HomeMy WebLinkAbout236586 08/27/14i
.� "^� CITY OF CARMEL, INDIANA VENDOR: 358709
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® ONE CIVIC SQUARE TERRY KILLEN CHECK AMOUNT: $ `"....132.09
;. r CARMEL, INDIANA 46032 333 S.UNION STREET CHECK NUMBER: 236586
'yCF6n Eo, WESTFIELD IN 46074 CHECK DATE: 08/27/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4343002 132.09 EXTERNAL TRAINING TRA
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SCA
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� 2014 Annual Street Commissioners Convention
vention
�(9 Registration Form: August 19th, 20th, 21st, 2014
www.indianastreets.org / /_
Name of Registrant Gc 117 00 d 1 Ifi
Address: C 010 L./ i
C Ct
Phone:
Spouse's Name (if attending):
E-Mail Address: qd
REGISTRATI®N 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 3uly 18th
After July 191h 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 (hospitality rooms) must contact; Brandie Petry at 812-936-9300 or E-mail:
bpetry(Wrenchlick.com
* Please complete and return registration form with payment by 3uly 18th 2014:
MAIL: CONVENTION REGISTRATION WITH PAYMENT TO
LARRY LEE SECRETARY/TREASURER
LEBANON STREET DEPARTMENT
1301 LAFAYETTE AVE
LEBANON, INDIANA 46052
oar,.af C4L41,
CITY OF CARMEL Expense Report (required for all travel expenses)
/NOIAMP
EMPLOYEE NAME: Terry Killen DEPARTURE DATE: 8/20/2014 TIME: AM / PM
DEPARTMENT: Street Department RETURN DATE: 21-Aug 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
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
8/20/14 $132.09 $132.09
$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
Totall $0.001 $0.00 $0.001 $0.00 $132.09 $0.00 $0.00 $0.001 $0.001 $0.001 $0.00 $132.09
DIRECTOR'S STATEMrNT: I here y affirrpjhat all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Q
Director Signature: d Date:
City of Carmel Form#ER06 Revision Date 8/22/2014 Page 1
2r:i
II
FRENCH LICK
RESORT
Name: TERRY KILLEN Arrival Date: 08/20/2014 CI Clerk APRATER
Address: 333 S UNION ST Departure Date: 08/21/2014 CO Clerk SWALLACE
WESTFIELD IN 46074 Group Code: 08131SC
Room #: FL 1 525 Resv 418685053457 Page 1 of 1
DateReference Description Charges Credits
08/20/2014 1418709000089 ROOM CHARGE FL 1525 119.00
TAX 1 8.33
TAX2 4.76
08/21/2014 41 871 5091 633 CASH PAYMENT FRENCH LICK 132.09
Total Due .00
I agree to remain personally liable for the payment of this account if the corporation or other third party
fails to pay part or all of these charges. I also agree that all charges contained in this account are correct
and any disputes or requests for copies of charges must be made within five (5) days after my departure.
If you are using a credit card, the hold may last up to 3 business days past your check-out date. If you
are using a debit card, the hold on funds may last from 7-10 business days after your check-out date.
Guest Signature:
French Lick Springs Hotel 8670 West St Road 56 French Lick, IN 47432
888.936.9360 frenchlick.com
� I
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))
08/21/14 $132.09
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
120-
Clerk-Treasurer
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Terry Killen
c/o Street Department IN SUM OF $
3400 W. 131 st St.
Carmel, IN 46074
$132.09
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO, I ACCT#/TITLE AMOUNT
Board Members
2201 ) I 43-430.021 $132.09 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
ti 014
reet Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund