232622 05/13/14 <�%'�c�q�� CITY OF CARMEL, INDIANA VENDOR: 00350442
® ��
ONE CIVIC SQUARE TROY D.SMITH CHECK AMOUNT: $*******362.36*
9. ?�; CARMEL, INDIANA 46032
CHECK DATE: 05/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 362.36 TRAINING SEMINARS
e
;\ CITY OF CARMEL Expense Report (required for all travel expenses)
\�ND10 /
EMPLOYEE NAME: Troy D Smith DEPARTURE DATE: 5/4/2014 TIME: 12:00 AM
DEPARTMENT: Police RETURN DATE: 5/6/2014 TIME: 7:00 AM(PM
REASON FOR TRAVEL: ISOA Conference DESTINATION CITY: Fort Wayne, IN
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM X
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total i
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
5/4/14 $106.18 $50.00 $156.18
5/5/14 $106.18 $50.00 $156.18
5/6/14 $50.00 $50.00
$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
$0.00
0.00
Total
$0.001 to.001 $0.00 $0.001 $212.36 $0.00 $0.001 $0.00r— $0.001 $0.001 $150.00
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: Date:
City of Carmel Form 9 ER06 Revision Date 5/7/2014 Page 1
HILTON FORT WAYNE AT THE GRAND WAYNE CONVENTION CENTER
Hilton T:
South Calhoun Street I Fort Wayne,IN 46802
T: 260 420 1100 1 F: 260 424 7775
FORT WAYNE AT THE GRAND WAYNE
CONVENTION CENTER W:hilton.Com
NKANWDRESS:
I rc Room: 909/D2
3 CIVIC SQ. Arrival Date: 5/4/2014 2:40:00 PM
Departure Date: 5/6/2014
CARMEL IN 46032
UNITED STATES OF AMERICA Adult/Child: 2/0
Room Rate: 87.00
Rate Plan: ISO
HH#
AL:
Car:
Confirmation NUrnber:3122599578
5/6/2014 Page: 1 U
n.
HILTON
HHONORS
DATE REFERENCE DESCRIPTION AMOUNT
5/4/2014 2207098 'PARKING $7.00
5/4/2014 2207099 GUEST ROOM $87.00 ,
5/4/2014 2207099 STATE TAX $6.09 �vntDoF
5/4/2014 2207099 OCCUPANCY TAX $6.09 "x,
5/5/2014 2207844 `PARKING $7.00
5/5/2014 2207845 GUEST ROOM $87.00
5/5/2014 2207845 S IATE TAX $6.09
5/5/2014 2207845 OCCUPANCY TAX _ CONRA_D
WILL BE SETTLED TO $212.36`
EFFECTIVE BALANCE OF
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ACCOUNTNO. DATEOFCIIARGE (OLIO NO./CHECK NO. AtRQ:urZ
492523 A
CARD MiMBER NAME AUTHORIZATION INITIAL
HOMEWOOD
Sl11Tc5
ESTABLISHMENT NO.&LOCATION PURCHASES&SERVICES
TAXES uu RRS�CC
ilo➢vIG
TIPS&MISC.
CARD MEMBER'S SIGNATURE TOTAL AMOUNT
0.00 cull
Hilton
MERCHANDISE AND/OR SFHVICES PURCHASED ON THIS f:A. SHALL NOT RE RLSOLDD-rOR RETURNED FOR A CASH REFUND. PAYMENT DUE UPON RECEIPT Gran..Vocations
FOA OFFICIAL USE ONLY ATT&A E
REGISTMTION
11th Annual Conference May 4th-6th
x$175 Conference Fee 0$20"Junkyard Shootout'Match
LI$25 Late Fee(After April 18,2014)
Total:$ ,75 •00 ❑Additional Banquet Tickets @$50 each
An application form must be submitted for each and every attendee
FIRST NAME M.I. LAST NAME
o D Sr-A% _
AGENCY ASSIGNMENT/RAN%/TFILE
CAWL QotrlGE DEPT• S&I 501FM TAMlkMM
AGENCY ADDRESS CITY STATE ZIP CODE
3 Ctvu Sa ?, CAILMEI ' sa 46012
MAILING ADDRESS(DTNER THAN AGENCY) CITY STATE ZIP CODE
EMAIL ADDRESSPNDNE�
�-ew�'�ir, Catn►c� J I 3��- 511-ZSba
1 affirm that the above information is�ccurate. Further, l authorize the Indiana SWAT Officers Association
to contact my employer and verify my employment and assignment, if necessary.
SN:NATURE DAIS
D3.11%-7)>
IMPORTANT. W111 you be attending the banquet? RYES ❑NO Number of additional tickets requested:
Federal Tax/D Number: 57-1177923
You are considered pre-registered if your registration form' and payment (agency purchase order, check, credit card', DOJ
voucher,or money order)are received prior to April 18,2014. Any registration form received after April 18,2014,will result in a
$25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be
purchased for$50.00 per ticket(limited quantity available).
*Registration fee includes: Attendance at Conference, Vendor Appreciation Day,lunch and
banquet dinner on Monday,May 5th,and lunch on Tuesday,May 6th
*There will be a$3.00 additional processing fee for credit card payments
If you are pre-registered and cancel prior to April 18, 2014, your registration fee will be refunded less a
$50.00 administrative charge. No refunds will be issued after April 18, 2014. However, suitable
substitutions will be allowed.
If paying by credit card,please complete the following: p VISA ❑ 4D O
CREDIT CARD NUMEER EXPIRATION DATE ]DIGIT Al11HONZATH7N CODE
NAME ON CREDIT CARD AUTHORIZATION SIGNATURE
ADDRESS CITY STATE ZIP CODE
IMPORTANT., Your credit card will be charged the day your registration form and payment are received by the ISOA.
Please Include the billing address where the monthly statement is sent
PLEASE CHECK. FULL-TIME ❑ PART-TIME ❑ RETIRED ❑AUXIuARY/RESERVE ❑ACTIVE MILITARY O RESERVE MILITARY
SUBMIT REGISTRA TION FORMPA MENT TO:
• •
R. • Box 1016
VOUCHER NO. WARRANT NO.
ALLOWED 20
Troy D. Smith
IN SUM OF$
$362.36
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
210 -570.00 $362.36 I hereby certify that the attached invoice(s), or
biil(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, May 09, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/09/14 Travel Expenses $362.36
1 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
Cierk-Treasurer