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Home My WebLink About239957 12/09/2014 CITY OF CARMEL, INDIANA VENDOR: 092500 ONE CIVIC SQUARE JOSEPH FAUCETT CHECK AMOUNT: $ ....'*90.00" CARMEL, INDIANA 46032 771 E 256TH ST CHECK NUMBER: 239957 SHERIDAN IN 46069 CHECK DATE: 12/09/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 90.00 OTHER EXPENSES 2014 IWEA Annual Conference very Registration BTOPPlease copy this form for additional registrations. HillsFor more information, visit: indianawea.org/conference Cancellations made after November 14 will be invoiced. FADDRESS r ty, � 0 First-time attendee 0 Life Member*�D/1�1'-� b� 0 Elected Official* 0 Honorary Member* 0 Young Professional (<35) 0 Tumblebug 0 Student CITY *Free conference registration—lunches not included STATE ZIP RE _ ION PHONE Me onmembe Member Nonmember EMAIL - •t �; �� a ,. ' :� r,x �`�`�,�:" . a O 1 Need Wastewater Credits •a, .:3 ��' :#tea;�� -�� } ., Cert. # Expir. '. v 0$145 0 $175 0$170 0$200 0 1 Need Drinking n Water Credits ' O$ • $1+75�•rt 1704 Cert.# Expir. 0$120 0$150 0$145 0$175 0 1Need Engineering PDHs " . h*.'t�". "�'.,'-'t'.'nv"5<1T��-...lJ i.?.i,N.+Fr•'i:.5'.'xt 0 $30 0 $30 0 $30 0$30 1. Mail form to: IWEA, 200 S Meridian St., Ste. 410, y. Indianapolis, IN 46225 ��I 1 't p " 6 �IANA 0o.$so. S,soz , ,z0$so ;os60 2. Fax form to: 317.686,2672 , ffin"?u -i.. ' R; is j.•r.. Water 3. Scan form and email to: = ; Environment TOTAL PO# sr. aherbertz@indianawea.org Association 4. Register online S pay by credit card: � Vegetarian a ', Indianawea,org/conference .' O Gluten-Free Other: 0 Lactose-Free Mattison Page 1 of 1 Thank you for registering for 78th Annual IWEA Conference. Please print page for receipt. Confirm Contact Information: First Name: Jordan Last Name: Kleinsmith Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email:jkleinsmith@carmel.in.gov Full Conference(does not include lunches or tours) $330.00 Friday Lunch—IWEA& WEF Awards $30.00 Total: $360.00 Number of I Registration: Total Cost: $360.00 Print https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 Mattison Page 1 of 4 Thank you for registering for 78th Annual IWEA Conference. Please print page for receipt. Confirm Contact Information: First Name: Robbie Last Name: Kinkead Employer: Cannel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email: rkinkead@carmel.in.gov Full Conference(does not include lunches or tours) $330.00 Friday Lunch—IWEA& WEF Awards $30.00 Total: $360.00 Confirm Contact Information: First Name: Lonnie Last Name: Patton Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email: 1patton@carmel.in.gov Full Conference(does not include lunches or tours) $330.00 Friday Lunch—IWEA& WEF Awards $30.00 Total: $360.00 Confirm Contact Information: First Name: Jason Last Name: Stewart https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 Mattison Page 2 of 4 Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email:jjstewart@carmle.in.gov Full Conference(does not include lunches or tours) $330.00 Friday Lunch—IWEA & WEF Awards $30.00 Total: $360.00 Confirm Contact Information: First Name: Joe Last Name: Faucett Employer: Carmel Utilities -WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email:jfaucett@carmel.in.gov Full Conference(does not include lunches or tours) $330.00 Friday Lunch—IWEA& WEF Awards $30.00 Total: $360.00 Confirm Contact Information: First Name: David Last Name: Dye Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email: ddye@carmel.in.gov https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 Mattison Page 3 of n4 Full Conference(does not include lunches or tours Friday Lunch—IWEA& WEF Awards $30.00 �� Friday Only(does not include lunch or tours) $145.00 Total: $505.00 \1' Confirm Contact Information: First Name: Craig Last Name: Carter Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email: ccarter@carmel.in.gov Friday Lunch—IWEA& WEF Awards $30.00 Friday Only(does not include lunch or tours) $145.00 Total: $175.00 Confirm Contact Information: First Name: Ed Last Name: Wolfe Employer: Carmel Utilities- WWTP Address: 9609 Hazel Dell Pkwy City: Indianapolis State: IN Zip: 46280 Phone: 317-571-2634 Email: ewolfe@carmel.in.gov Friday Lunch—IWEA& WEF Awards $30.00 Friday Only(does not include lunch or tours) $145.00 https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 Mattison Page 4 of 4 Total: $175.00 Number of 7 Registration: Total Cost: $2,295.00 Print https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 �1V`ar C/!q 1 CITY OF CARMEL Expense Report (required for all travel expenses) l I -•<N�,pN?-�` EXHIBIT A EMPLOYEE NAME: Joe Faucett DEPARTURE DATE: TIME: AM / PM DEPARTMENT: Utilities/Sewer RETURN DATE: TIME: AM / PM REASON FOR TRAVEL: _Seminar/Convention DESTINATION CITY: Indianapolis EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 11/19/14 $30.00 $30.00 11/20/14 $30.00 $30.00 11/21/14 $30.00 $30.00 $0.00 $0.00 $0.00 $0.00 I $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 1 $0.00 $90.00.F $0.00 $0.00 $0.00 $0.00 $0.00 . •$0.00 $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 11/24/2014 Page 1 a: r. z For advance payments, claim form must be submitted ten (10) business days in advance of travel. Claim will not be processed without the following documentation: 1) Conference or course registration form, if applicable 2) Travel itinerary or car rental agreement, if applicable 3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt) Prorated meal allowance: For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in-state travel and $60 for out-of-state travel For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in-state travel and $30 for out-of-state travel For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in-state travel and $30 for out-of-state travel For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in-state travel and $60 for out-of-state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of$ , such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen. I understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to: 1) Submit original itemized receipts to the office of the Clerk-Treasurer documenting all meal expenditures; and 2) Return all unused funds to the office of the Clerk-Treasurer further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: City of Carmel Form#ERO6 Revision Date 11/24/2014 Page 2 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 T9980 FAUCETT, JOSEPH Purchase Order No. Wastewater Terms Due Date 12/3/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/3/2014 FAUCETT, J1 $90.00 hereby certify that the attached invoice(s), or bill(s) is (pre) true and correct and I have audited same in accordance with IC 5-11-10-1.6 Date icer VOUCHER # 146102 WARRANT # ALLOWED T9980 IN SUM OF $ FAUCETT, JOSEPH Wastewater Carmel Wastewater Utility i ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code FAUCETT,JC 01-7042-06 $90.00 i Voucher Total $90.00 Cost distribution ledger classification if claim paid under vehicle highway fund