HomeMy WebLinkAbout237086 9 /16/2014 ' .meq
%' \� CITY OF CARMEL, INDIANA VENDOR: 065950
�; ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: $*******557.40*
r•. J=� CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK NUMBER: 237086
+,;, CARMEL IN 46033-9501 CHECK DATE: 09/16/14
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 122.08 MILEAGE
1701 4343004 435.32 TRAVEL PER DIEMS
Google Maps https://www.google.com/maps/preview?11=41.076109,-85.14056&z...
Google
Drivel 09 miles, 1 h 45 min
Directions from 1 ' - Oir to 200-226 W Jefferson Blvd
Q _ __ _.......� ___, :I r A This route has restricted usage or private roads,
Carmel, IN 46033
Get on 1-69 N in Fishers from E 116th St
5.5mi/13min
t 1. Head north on Cir toward
, . Restricted usage road
472 ft
41 2. Turn left onto Pebblepointe Pass
A Restricted usage road
0.4 mi
r 3. Take the 2nd right onto Stonewick Run
A Restricted usage road
397 ft
41 4. Turn left onto E 116th St
4.0 mi
5. Slight right onto the Interstate 69 N ramp to Fort Wayne
0.9 mi
Follow 1-69 N to W Jefferson Blvd in Aboite. Take exit 302 from 1-69 N
96.6 mi/1 h20min
6. Merge onto 1-69 N
– — - 96.1 mi
7. Take exit 302 for Jefferson Blvd toward US 24 W
0.4 mi
8. Keep right at the fork,follow signs for Fort Wayne and merge onto W Jefferson Blvd
325 ft
Merge onto W Jefferson Blvd
Destination will be on the left
6.9mi/12min
p 200-226 W Jefferson Blvd
Fort Wayne, IN 46802
These directions are for planning purposes only.You may find that construction
projects,traffic,weather,or other events may cause conditions to differ from the
map results,and you should plan your route accordingly.You must obey all signs or
notices regarding your route.
I of 2 9/15/2014 1:12 PM
Prescribed by State Board of Accounts General Form No.101 (1955)
MILEAGE CLAIM
CTO �WV`-�- DR.
(Governmental Unit)
e-
� / ' On Account of Appropriation No. � for
(Office,Board, Department or Institution)
DATE FROM TO ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE @
20 l Point Point Start Finish TRAVELED PER MILE
nL
� II
Auto License No. TOTALSL
*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 claimed is legally due, after
allowing all just ccrrredi ,, and that no part of the same has been paid. i
Date
f
I
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
I111FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
} �g That it is apparently correct
1 $ I incorrect
4
On Account of Appropriation No. for
Disbursing Officer
II
IN
fAllowed 20 o. Cr
I
in the sum of$ o -
La
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(D
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j (Board or Commission) ;.y O
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Aftftaft CITY OF CARMEL Expense Report (required for all travel expenses)
Aap EXHIBIT A
EMPLOYEE NAME: DIANA CORDRAY DEPARTURE DATE: q IR 114 TIME: �D AM PM
DEPARTMENT: RETURN DATE: ��, /(� TII,MAE:: AM/PM
REASON FOR TRAVEL: L±kret l V DESTINATION CITY: f U'ILLId
TRAVEL PER EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT R DIEM
Transportation Meals
Date Gas/Tolls/ Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
9/9/14 $7.00 $135.66 $50.00 $192.66
9/10/14 $7.00 $135.66 1 $50.00 $192.66
9/11/14 $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 $0.00 $0.00 $0.00 $14.00 $271.32 $0.00 $0.00 $0.00 $0.00 $150.00 $0.00
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 9/15/2014 Page 1
2014 IACT ANNUAL CONFERENCE & EXHIBITION REGISTRATION FORM
Pre-Registration Deadline: August 21
Full Name a1&, Phone +(-?
Preferred Name for Badge Email d
Title Ch � � (���$ Spouse/Guest Name –r
Municipality/Company yyx,P,�l Special Needs and Dietary Restrictions
Council President's Name ;Eric') Se4 e4t-d<e
Address Dh pe (21 V C
City/State/Zip
REGISTRATION FEES METHOD OF PAYMENT
On/Before After Enter
8121 8/21 Amount Check ❑ Visa ❑ MasterCard ❑ Discover.
[ACT Member—Municipal Official $325 $375 Check#(Payable to IACT).
(Pop,greater than or equal to 1,000)
Cardholder Name
IACT Member—Municipal Official $190 $240
(Pop.less than 1,000) Credit Card Number
[ACT Associate Member $325 $375 Expiration Date
Spouse/Guest" $190 $240 3-digit Verification Code
Non Member r $475 $525} Billing Address
Municipal Day(Wednesday Only) $250 $300 City/State/Zip
Total Amount: $ Signature of Cardholder
"The spouse/guest registration fee is restricted to those who are not municipal ofFlcials and who have no professional Interest in the conference.The fee includes admission
to all conference events,the exhibit hall,meals and participation in the spouse/guest program.[ACT is planning a number of fun activities for guests of conference attendees.
Visit www.citiesandtowns.org/ac for more information as it becomes available.
Please Check•the Conference Events You.Plan to Attend(For planning purposes only) . • �.•
❑TUESDAY,.Open ❑TUESDAY, ❑,TUESDAY,• ❑TUESQAY, ❑TUESDAY, ❑WEDNESDAY„ ❑WEDNESDAY, 0 WEDNESDAY,,
Ing Business Woikshop#1: Workshop 42: Welcome`' City of Fort Wayne Continental ilorival Awards" Presidents'
Session Parks Workshop Funding Reception In Welcome Party Breakfastin Luncheon ..Reception
Workshop Exhibit Hall Exhibit Hall
❑THURSDAY,
Closing Brunch&
Business Session
Cancellation Policy Special Needs and Dietary Restrictions Questions?
Only written cancellations will be accepted.Please mall your If you require special arrangements or a special diet,please Contact Natalie Hurt at 317-237.6200 ext.233 or
written cancellation to 125 W.Market SL,Suite 240,India- notify TACT on your registration form. nhun®citiesandtowns,org
napolis,IN 46204;fax to(317)237-6206 or send to nhun@
citiesandtowns.org.Written cancellations received on or Affiliate Group Events
before August 21,will be refunded less a$40 processing fee. TACT affiliate groups may hold individual meetings and E-Verity Compliance
[ACT is not responsible for hotel reservations or cancellations. events at the conference.Attendees must be registered IACT is an enrolled employer in the E-Verify Program verify-
for the conference in order to attend affiliate events. Ing the work eligibility status of its new employees and will
Additional Information for affiliate group members may be remain so until that program no longer exists.
mailed out separately.
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HILTON FORT WAYNE AT THE GRAND WAYNE CONVENTION CENTER
Hilton 1020 South Calhoun Street I Fort Wayne,IN 46802
T: 260 420 1100 1 F: 260 424 7775
FORT WAYNE AT THE GRAND WAYNE
Npp
CONVENTIONCENTERW:hilton.com
CORDi�AY, DIANAS Room: 831/D21
11843 STONEY BAY CIR
Arrival Date: 9/9/2014 10:44:00 AM
Departure Date: 9/11/2014
CARMEL IN 46033-9501
UNITED STATES OF AMERICA Adult/Child: 1/0
Room Rate: 119.00
Rate Plan: IAC
HH# 348692524 SILVER
AL: US#999L7R4
Car:
Confirmation Number:3139999365
9/11/2014 Page: 1 U
n.
HILTON
HHONORS
DATE REFERENCE DESCRIPTION AMOUNT
9/9/2014 2284998 "PARKING $7.00
9/9/2014, 2284999 GUEST ROOM $119.00 `
9/9/2014 2284999 STATE TAX $8.33 WALDOR•'
9/9/2014 2284999 OCCUPANCY TAX $8.33 '
9/10/2014 2285803 *PARKI G $7.00
9/10/2014 2285804 T ROOM $119.00
9/10/2014 2285804 STATE TAX $8.33 C O N R A D
9/10/2014 2285804 OCCUPANCY TAX- $8.33 �_E_....••__
WILL BE SETTLER TO $285.32
EFFECTIVE BALANCE OF $0.00
You have earned approximately 2898 Hilton HHonors points and approximately 252 Miles with US Airways for this stay_Hilton__
- - '-HHono�s(R)`stays are posted within 72'hours of checkout.To chHilton
eck your earnin
4 is;4w1
Thank you for choosing Hilton.You'll get more when you book directly with us-more destinations, more points,and more value.Book
your next stay at hilton.com.
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CARD MEMBER NAME AUTHORIZATION INITIAL
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ESTABLISHMENT NO.&LOCATION ESTARLLSHMENT AGREES TO TRANSMRTO WIG HOWER FOR PAITSEHT PURCHASES&SERVICES
TAXES
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CARD MEMBER'S SIGNATURE TOTALAMOUNT
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MERCHANDISE AND/ORSERVICES PURCHASEDON THIS CARD SHALL NOT BE RESOLD OR RETURNED FOR ACASH REFUND. PAYMENT DUE UPON RECEIPT r.ErandV7Catlans
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��' U, Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
-D ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
C7-:47 �Dlo,&l
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
20
ig ature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund