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HomeMy WebLinkAbout232622 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 14 tx�cRT s3:u�T: I taan sx� y ssirtix 'lSAGuIx Gurclen iGta y.z. 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