HomeMy WebLinkAbout236405 08/27/14 ��.�,A+, CITY OF CARMEL, INDIANA VENDOR: 357304
`/ '1. CHECK AMOUNT: $*******176.66*
.(; ® � ONE CIVIC SQUARE JAMES HOBBS
d ;?�; CARMEL, INDIANA 46032 11180 E.111TH STREET CHECK NUMBER: 236405
9.y�«oN�, FISHERS IN 46038 CHECK DATE: 08/27/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4343002 176.66 EXTERNAL TRAINING TRA
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2014 Annual Street Commissioners Convention
Registration Form: August 19th, 20th, 21St, 2014
www.indianastreets.org
Name of Registrant Gc.a-7 10
Address: G 010 L./ i
Phone: C7 3
Spouse's Name (if attending):
E-Mail Address:
REGISTRATION FEE MUST BE ENCLOSED. WITH FORM �
Current ISCA Member $150.00 per person (Includes Meals)
J_ Asst. Commissioner/Foreman $150.00 per person (Include Meals)
Additional Registration $150.00 per person (Includes Meals)
Vendor Registration $300.00 (Includes Meals & Vendor Cookout) with NO BOOTH
Vendor Registration $500.00 (Includes Meals & Vendor Cookout) with BOOTH
Space and (1) employee
(Limited booth area — no more than 40 booth areas)
All hotel accommodations must be made with a credit card:
French Lick Resort
8670 West State Road 56
French lick, IN 47432
(T) 812-936-9300 or 888-936-9360
(F) 812-936-5586
* When making hotel reservations, let the hotel know you are with I.S.C.A. and Group Code is
0813ISC
*The room rates are $119.00 dollars for I.S.C.A. members they will be guaranteed until July 18th
After July 19th rooms will be released to the public. Cancellation must be made four days prior to
arrival for full refund of deposit. Check-in time is at 4:00 p.m. Check-out is at 11:00 a.m.
* Vendors who want (hoEoitality rooms) must contact; Brandie Petry at 812-936-9300 or E-mail:
bnetry@frenchlick.com
* Please complete and return registration form with payment by JuIV lath 2014:
MAIL: CONVENTION REGISTRATION WITH PAYMENT TO
LARRY LEE SECRETARY/TREASURER
LEBANON STREET DEPARTMENT
1301 LAFAYETTE AVE
LEBANON, INDIANA 46052
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Jim Hobbs DEPARTURE DATE: 8/21/2014 TIME: AM/ PM
DEPARTMENT: Street Department RETURN DATE: 8/22/2014 TIME: AM/PM
REASON FOR TRAVEL: Road School Class DESTINATION CITY: French Lick
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT x PER DIEM
Transportation Gas/TolIs/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
8/21/14 $9.78 $9.78
$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
$0.00
0.00
Total $0.00 1 $0.001 $0.00 $0.00 $0.00 $0.00 $9.781 $0.001 $0.00 $0.00 $0.00 $9.78
DIRECTOR'S STATEMENT: I hereb affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 8/22/2014 Page 1
Prescribed by State Board of Accounts General Form No.101(1955)
/� MILEAGE CLAIM
C�a l e f �er
ThiI 'A�, TOF1_enc, r C IC �L�[ 5C-GO/ (...-C Ci o DR
Governmentalunit)
On Account of Appropriation No. for
Office,Board,Department or Ins6tubon
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @
201 Point Point Start Finish TRAVELED r PER MILE
ZO t C16 92
j
Auto License No. TOTALS ,
*SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct,that the amount c ed' all a
allowing all just credits,and that no part of the same has been paid.
Date
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jim Hobbs
IN SUM OF$
c/o Carmel Street Department
$176.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#IrITLE AMOUNT Board Members
2201 43-430.02 j $166.88 1 hereby certify that the attached invoice(s), or
2201 43-430.02 $9.78 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
F ay, 14
—7 _ U
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))
08/20/14 $166.88
08/21/14 $9.78
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