HomeMy WebLinkAbout238583 10/28/14 CITY OF CARMEL, INDIANA VENDOR: 362003
1_ ONE CIVIC SQUARE JEFFREY CAPSHAW CHECK AMOUNT: $*******175.00*
CARMEL, INDIANA 46032 323 THORNBERRY DRIVE CHECK NUMBER: 238583
CARMEL IN 46032 CHECK DATE: 10/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4343002 175.00 EXTERNAL TRAINING TRA
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Jeff Capshaw DEPARTURE DATE: TIME: AM/
DEPARTMENT: FIRE RETURN DATE: \Q -`fie -�� TIME: y AM PM
REASON FOR TRAVEL: Hazard Zone Conference DESTINATION CITY: Notre Dame, Indiana
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$0.00
10/19/14 $25.00 $25.00
10/20/14 1 $50.00 $50.00
10/21/14 $50.00 $50.00
10/22/14 $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
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $175.00 $0.00 1
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.
OCT Z 7 201
Director Signature: Date:
r .
City of Carmel Form 9 ER06 Revision Date 10/24/2014 Page 1
Red Roof Inn Mishawaka-Notre Dame
1325 East University Drive Court
Granger, IN 46530 US
Phone: 574-271-4800
®
Fax: 574-271-0956
Email: i0629@redroof.com
Printed: 10/22/2014 6:54:47 AM
Folio (Detailed)
Name: BUTTLER, JIM Confirmation Number: 282629-3339
Address: 5 CIVIC
CARMEL, IN US
Room: 216 Roam Type: NS2Q, NON-SMOKING STI ANDARD 2 QUEEN.BEDS
Nights: 3 Guests: 2/0
Rate Plan: GOV Daily Rate: $58.99 + $0.00 Tax GTD: 900 - CASH
Arrival: 10/19/2014 (Sun) Departure: 10/22/2014 (Wed)
Room Rate:
10/19/2014 (Sun) - 10/21/2014 (Tue) $58.99 + $0.00 Tax per night.
Date Code Description Amount Balance
10/1/2014 901 CHECK ($176.97) ($176.97)
10/19/2014 100 ROOM CHARGES $58.99 ($117.98)
10/20/2014 100 ROOM CHARGES $58.99 ($58.99)
10/21/2014 100 ROOM CHARGES $58.99 $0.00
Summary
Room Tax F&B Other CC Cash DB
$176.97 $0.00 $0.00 $0.00 $0.00 ($176.97) $0.00
.x Invoice
Across the Street Productions
19141 Stone Midge Drive-Suite A Date - Invoice
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South Send, Indiana 46637 816/2014 12-2294T
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I Bill To
Carmel Fire Department
Denise Snyder
12 Civic Square
Carmel, IN 46032
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P.O. No. Terms Due Date
Hazard Zone Conf j Net 30 915/2014
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Quantity �_.f Description Rate Amount
9 Hazard Zone Conference 2014; Buttler, Hoffman, Hensley, 445.00 4,005.00
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Capshaw, Steele, Brandt,Toney, Stindle, Peterson ! {
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Train the Trainer invoices nau;t be paid 14 days prior to the start of cis"
Total I
Make Checks Payable to:
Across the Stmet Productions
phone (574)273-0%, 2 Toll lZrce (&55)872-SV-2 ; Fax(574)273-3174 W to vwf"4
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Hazard Zone
_ HER C-
Managem
Conference
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Event: 2014 Brunacini Hazard Zone Management and Leadership Conference-Notre Dame,IN
Dates: Start 10/2012014 End:10122/2014
Location:
Notre Dame,Indiana 46556
Description:
The Brunacini's have again collaborated with the leading fire service instructors to hast their 5th
Annual Hazard Zone Management and Leadership Conference.Please Jain Usll October 20-22,
2014 at the beautiful Notre Dame campus In South Bend,Indiana.
Click to view conference agendafsessloms
Click to view conferencie flyer,
This years conference will feature:
• Laurence Gonzales.-Author of"Deep.Survival:--Who fives,Who:dies,and Why"
• Scott.Penin-Retired Phoenix FD,AZ Battalion Chief,C.E_O,of TIGNUM and author of"Sink,
Float,or Swim"
• Alan,Nick,and John Brunacini-Hazard:Zone Management
• Gordon Graham-Retire CHIP's Captain.Risk Manager,and President of Lexipol
•
Terry Garrison-Fire Chief Houston,TX
• Along with many morel
Instructors-Click,here for your 3200.00-snac121.
After June 1,2014 regular registration rate of$445.00
Hotel Accommodations:
When calling the hotels for special rates please mention that your reservations.are for the
"Brunacini Hazard Zone Conference at Notre Dame".
Fairfield Inn and Suites at Notre Dame
Please use the falibwing link to makei reservations at the Fairfield:
http://cwp.marriott.00misbnnd/brunacinihazardzone/
1220E Angela Blvd
South.Bend,IN
(574)234-5510
Approximate Rates:
'StandardKing-$111.00
*Standard Queens$115.00
*King Suites$115.00
Wilton Garden Inn South Bend—Group
Website: httpJ/hiltongardeninn3.hilton.00m
53995 Indiana 933
South Bend,IN 46637
(574)232-7700
Approximate Rates:
https://www.bshifter.com/SelectB lueCardCommand.aspx?view=V iewDetail&event,aWd=3b809fD... 8/14/2014
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jeff Capshaw
IN SUM OF $
$175.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
i
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-430.02 $175.00 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
7
Fire Chief
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))
$175.00
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