HomeMy WebLinkAbout239369 11/19/14 \. CITY OF CARMEL, INDIANA VENDOR: 368458
I; 31 ONE CIVIC SQUARE HANI SOUEIDAN CHECK AMOUNT: $*******382.56*
,a CARMEL, INDIANA 46032 CARMEL WASTEWATER CHECK NUMBER: 239369
M,,�sN�• CHECK DATE: 11/19/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 382.56 OTHER EXPENSES
CITY OF CARMEL Expense Report (required for all travel expenses) a
EXHIBIT A
EMPLOYEE NAME: Ham swjZCIO.14 DEPARTURE DATE: li �
l yl y TIME: W,00 AM :PM . ,
DEPARTMENT:_Sewer RETURN DATE: f I�-7jN TIME: AMAS
REASON FOR TRAVEL:_Training DESTINATION CITY: Ffe.4ck f±%'ckT;c(ia;fCj;--'
EXPENSES ARE FOR(check all that apply):TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. 030t
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 01",
11/4/14 $50.0001O o
00
11/5/14 $.50.00 99,0$l6.OYLq0
11/6/11 $50.00 Q0
11R/1 $50.00 $50 O:UE
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'}� ,-4E o=00
` $r0.1
$(01
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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 11/13/2013 Page 1
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November 5-7, 2014 Registration: Early Bird Special
French Lick Hotel and Conference Center, French Lick, Indiana Available until August 29, 2014.
The Midwest Damage Prevention Training Conference will be held Nov. 5-7, 2014 at the French Lick Resort, the top
conference center in one of the best conference towns in the Midw- -1 Li k Indiana.
If you have any questions or want to inquire about special l overnment rate please email emeier @mghus.com.
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BILLING INFORMATION FOR CREDIT CARD PURCHASES (To pay by check please call 410-902-5054 for more information.)
First Name Last Name
Name on Credit Card
Credit Card Billing Address
Phone Number
Type of Card ❑Visa ❑ MasterCard ❑ American Express
Card Number
Expiration Security Code
PLEASE SUBMIT YOUR REGISTRATION FORM TO EMILY MEIER BY EMAIL AT EMEIER @MGHUS.COM.
Thank you so much for registering for the 2014 Midwest Damage Prevention Training Conference!
Prescribed by State Board of Accounts MILEAGE CLAIM General Form No.101(1955)
TO DR.
(Governmental Unit
On Account of Appropriation No. I for
Office,Board,Department or Institution)
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @ ,4 6
20/ Point Point Start Finish 1 TRAVELED PER MILE
#I e- ` nJ r c c c O a .11 r Ve ce / a
Auto License No. TOTALS (0
*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 credits, and that no part of the same has been paid.
Date j2
VOUCHER # 145990 WARRANT # ALLOWED
368458 IN SUM OF $
SOUEIDAN, HANI Y
SOUTH PLANT
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
SOUBDAN, h 01-7040-01 p $200..00
0I .7o4o-oi
38, ,,
Voucher Total 6'
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
368458
SOUBDAN, HANI Y Purchase Order No.
SOUTH PLANT Terms
Due Date 11/13/2014
Invoice Invoice Description
Date Number .(or note attached 'invoice(s) or bill(s)) Amount
11/13/201, SOUEIDAN, $200.00
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- .6
Date �6fficer