HomeMy WebLinkAbout230455 03/26/14 CITY OF CARMEL, INDIANA VENDOR: 120950
d s? ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $*****1,373.70*
CARMEL, INDIANA 46032 C/O DEPT OF LAW CHECK NUMBER: 230455
9M_roN. C/O DEPT OF LAW CHECK DATE: 03/26/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343002 1,373.70 EXTERNAL TRAINING TRA
STATE OF INDIANA )
SS:
COUNTY OF HAMILTON )
AFFIDAVIT
I, Douglas C. Haney, being first duly sworn upon my oath, state that while I was on City business
attending ALUCLE seminar on Employment Law in Washington, DC, February 2/27/14-3/2/14, I
expended $72.00 of my own money for parking at the Indianapolis Airport and for which I need to be
reimbursed.
Dated this odd day of March, 2014.
Deng as C. Haney
Subscribed and sworn to before me, the undersigned Notary Public, this day of March, 2014.
AMANDA BENNETT
NOTARY PUBUC,SEAL
STATE Of INDIANA
RESIDENT Of MARION COUNTY
COMMISSION NO.599586 Amanda Bennett, NOTARY PUBLIC
MY COMMISSION EXPIRES: 1-5-2017
Resident of Marion County, Indiana
My Commission Expires:
January 5/2017
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CITY OF CARMEL Expense Report (required for all travel expenses)
u
NDI AN A
EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 02/27/14 6::00 AM
DEPARTMENT: Law Department RETURN DATE: 03/02/14 TIME: 4:4500 PM
REASON FOR TRAVEL: ALI/CLE Advanced Employment Law DESTINATION CITY: Washington, DC
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
2/27/14 $65.00 $65.00
2/28/14 $65.00 $65.00
3/1/14 1 $65.001 $65.00
3/2/14 $65.00 $65.00
$0.00
2/27/14 $488.00 $488.00
2/27/14 $10.00 $10.00
2/27-
3/2/14 $540.45 $540.45
2/27-3/2 $72.00 $72.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
Total $488.00 $0.00 $10.00 $72.00 $540.45 $0.001 $0.001 $0.00 $0.00i $260.00 $0.00 0
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date: fflhA( � � I 0�y
City of Carmel Form 9 ER06 Revision Date 3/20/2014 Page 1
Mon 81514TH NW
Gaardenffiff
WASHINGTON,DC 20005
TELEPHONE(202)783-7800 FAX(202)783-7801
RESERVATIONS
NAME&ADDRESS www.hilton.com or 1 800 HILTONS
HANEY,DOUGLAS ROOM 1114/K1
- ARRIVAL DATE 2/27/2014 10:42:OOAM
CARMEL,IN 460339101
US DEPARTURE DATE 3/2/2014 10:33:OOAM
ADULT/CHILD 1/0
ROOM RATE $151.00
RATE PLAN L-AA
Hhonors#
AL:
CONFIRMATION NUMBER: 3116081459
3/2/2014 PAGE 1
DATE DESCRIPTION j ID REF NO CHARGES CREDITS BALANCE
2/27/2014 GUEST ROOM JJR 3712556 $151.00
2/27/2014 I WASHINGTON,DC ROOM TAX JJR 3712556 $21.90
2/28!2014 GUEST ROOM JJR 3713485 $151.00
2/28/2014 WASHINGTON,DC ROOM TAX !JJR 3713485 $21.90
3/1/2014 GUEST ROOM I JJR 3714299 $170.00
3/1/2014 WASHINGTON.DC ROOM TAX JJR 3714299 $24.65
3/2/2014 YESSENIA 3714773 $540.45
BALANCE $0.00
Hilton HHonors(R)stays are posted within 72 hours of checkout. To check your earnings or book your next stay at more than 3,900 hotels and
resorts in 91 countries,please visit HHonors.com. 0
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ACCOUNT NO DATE OF CHARGE FOLIO
03/01/14 7:13:OOAM 691000 A
CARD MEMBER NAME AUTHORIZATION INITIAL
HANEY,DOUGLAS 907224
ESTABLISHMENT NO& ESTABLISHMENT AGREES TO PURCHASES&SERVICES
LOCATION TRANSMIT TO CARD HOLDER FOR
TAXES
TIPS&MISC
TOTAL AMOUNT
I
MERCHANDISE AND/OR SERVICES PURCHASEDON THIS CARD SHALL NOT BE RETURNED FOR A CASH REFUND
PAYMENT DUE UPON RECEIPT
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City FormNo.201(Rev.1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Douglas C. Haney
Purchase Order No.
Terms
Carmel, Indiana 46033
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/20/14 43002 Reimburse Douglas C. Haney for monies he personally $1,370.45
expended during the 2/27/14 ALI/CLE Employment Law
Seminar-per attached receipts
Total
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
—Deug'asG• Haney IN SUM OF $
Carmel, Indiana 46033
$ $1,370.45
ON ACCOUNT OF APPROPRIATION FOR
Department of Law - 1180
430-43002 External Training Travel
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 43002 $1,370.45 or bill(s) is (are) true and correct and that
the materials or services itemized thereon
for which charge is made were ordered and
received except
20
nature
Cost distribution ledger classification if T tle
claim paid motor vehicle highway fund
STATE OF INDIANA )
) SS:
COUNTY OF HAMILTON )
AFFIDAVIT
1, Douglas C. Haney, Carmel City Attorney, being first duly sworn upon my oath, state that while
participating in the Indiana Municipal Law Seminar on March 7, 2014, in Indianapolis, Indiana, on behalf
of the City of Carmel, I personally deposited Three Dollars and Twenty Five rents ($3.25) of _rnv owq _ _
money into a parking meter for which I need to be reimbursed.
Dated this a day of March, 2014.
DougL s . ney
Subscribed and sworn to before me, the undersigned Notary Public, this day of March,
2014.
AMANDA BENNETT
NOTARY PUBLIC,SEAL
STATE OF INDIANA
RESIDENT OF MARION COUNTY
COMMISSION NO.599586
MY COMMISSION EXPIRES:1-5-2017 Amanda Bennett, NOTARY PUBLIC
Resident of Marion County, Indiana
My Commission Expires:
January 5, 2017
[eb:—d:\Vss,rapps1\—data-ad,mnVawWnrcd\afr.daits\affadisit iact 1 marking—t—d-3/20/141
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Douglas C. Haney
Purchase Order No.
Terms
Carmel, Indiana 46033
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/20/14 43002 Reimburse Douglas C. Haney for monies he personally $3.25
3%7/2014 Indiana Municipal Law Seminar
Seminar-per attached affidavit
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance
ccordance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Deuglas G. Haney IN SUM OF $
Carmel, Indiana 46033
$ $3.25
ON ACCOUNT OF APPROPRIATION FOR
Department of Law - 1180
430-43002 External Training Travel
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 43002 $3.25 or bill(s) is (are) true and correct and that
the materials or services itemized thereon
for which charge is made were ordered and
received except
MCk(Ch oho 20
ignature
I
Cost distribution ledger classification if "title
claim paid motor vehicle highway fund