232425 05/12/14 0;`�or 44gyF
CITY OF CARMEL, INDIANA VENDOR: 362874
ONE CIVIC SQUARE CHRIS ROHR
`'/ CHECK AMOUNT: $******"260.00*
.�a
CARMEL, INDIANA 46032 CHECK NUMBER: 232425
�`' ��0. CHECK DATE: 05/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4343002 260.00 EXTERNAL TRAINING TRA
Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me
if you wish to pay via credit card. I will call you to complete the registration.
2014 KTA Symposium Registration
The 2014 Registration fee for KTA is X ff per attendee. Checks can be made payable to
City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to
use a credit card please include a daytime phone number and I willcontact you to get the
necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR
PAYMENT! Each participant MUST complete the form. Please choose between Pipes and
Drums or Honor Guard but not both.
Name
Department Name
Department City1, �
Department State
Cell Phone
Email Address
Please circle the appropriate response:_
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
Pipes
Beginner Intermediate Advanced****
****Advanced players will be required to audition for this group on day-one -
rum
Tenor Bass
Beginner ntermed!g„ Advanced
Will you require transportation from the airport Yes
OF CAAV
CITY OF CARMEL Expense Report (required for all travel expenses)
/NOIFN'
EMPLOYEE NAME: ���� ����c DEPARTURE DATE: '`� -\y TIME: �� M
DEPARTMENT: � � RETURN DATE: TIME: AM P
REASON FOR TRAVEL: DESTINATION CITY: 11-11 -,,a-w --,;;�, /
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEMy
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Parkin
Air-fare Car Rental Other 9 Breakfast Lunch Dinner Snacks Per Diem
$0.00
5/7/14 $65.00 $65.00
5/8/14 1 1 $65.00 $65.00
5/9/14 $65.00 $65.00
5/10/14 $65.00 $65.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: fi&�= Date: MAY 12 2014
City of Carmel Form#ER06 Revision Date 5/12/2014 Page 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
Chris Rohr
IN SUM OF$
$260.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-430.02 $260.00 1 hereby certify that the attached invoice(s), 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 MAY 12 2014
A
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
i
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
lil 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$260.00
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer