HomeMy WebLinkAbout240156 12/09/14 �%r.�p�"• CITY OF CARMEL, INDIANA VENDOR: 00350947
�• ONE CIVIC SQUARE W EDWARD WOLFE CHECK AMOUNT: $********30.00*
''' •10 22934 ANTHONY ROAD CHECK NUMBER: 240156
r. ,_, CARMEL, INDIANA 46032
,,;��'ON�� CICERO IN 46034 CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 30.00 OTHER EXPENSES
2014 IWEA Annual Conference
NNY Registration Form
Please copy this form for additional registrations.
For more information, visit: indianawea,org/conference
Cancellations made after November 14 will be invoiced.
i
rNAME � �
JQ soA S f `�� 0 First-time attendee 0 Life Member*
EMPLOYER
�— 0 Elected Official- 0 Honorary Member*
ADDRESS O Young Professional (<35) O Tumblebug
O Student
CITY *Free conference registration—lunches not included
STATE ZIP RE I O 1 V
PHONE
Me onmembe Member Nonmember
EMAIL
Q$280 Q'$310 ` 0`$330 X40$360
lunch, to
es
• O 1 Need Wastewater Credits .. •
• 0$145 0$175 0$170 0$200
Cert.# Expir,
y
•• • { t r ,ir rye K ,� 'ti k �
O 1 Need Drinking Water Credits ;O$145 Q$175 t `0$170 r
Cert.# Expir. •• •
0$120 0$150 0$145 - 0$175
• O 1 Need Engineering PDHs
ti
•• - E 1 t Y 3
0 $30 0 $30 0 $30 0$30
1. Mail form to: IWEA, 200 S Meridian St., Ste. 410,
Indianapolis, IN 46225
2. Fax form to: 317.686,2672 iND�ANA ;
Water TOTAL PO#
3. Scan form and email to: r Environment
aherberiz@indianawea.org Association
0
4. Register online S pay by credit card: Vegetarian i .
indianawea.org/conference 0 Gluten-Free
Other: 0 Lactose-Free
Thank you for registering for 78th Annual IV EA 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 1
Registration:
Total Cost: $360.00
Print
https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014
Thank you for registering for 78th Annual IWEA Conference.
Please print page for receipt.
Confirm Contact Information:
First Name: Robbie
Last Name: Kinkead
Employer: Carmel 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: 1pattoti@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
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
I
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
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
II
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_
Total: $175.00
Number of 7
Registration:
Total Cost: $2,295.00
Print
https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014
� 1
CITY OF CARMEL Expense Report (required for all travel expenses)
%pNp ' EXHIBIT A
EMPLOYEE NAME: Ed Wolfe 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
11/21/14 $30.00 � $30:00
$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
MOD
0.00
Total $0:00 -$0.00 $0.00 $30:00 $0.00 $0.00 00 $0:00` i. 0
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
i
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 registration11form, if applicable
2) Travel itinerary or car'ental agreement, if applicable
3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diem)s (which require hotel receipt)
f I
Prorated meal allowance:
For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in-state traveliand $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 four 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 $60 for out-of-state travel
L
I
EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES:
I hereby acknowledge receipt of$ ;i 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 (1 b) business day�s of my return (as stated on opposite side), I am responsible to:
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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
i
I 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:
' I
City of Carmel Form#ER06 I Revision Date 11/24/2014 Page 2
i
a
VOUCHER # 146101 WARRANT # i ALLOWED
I
T1032
IN SUM OF $
Wolfe, Edward
WWTP
I.
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT y Audit Trail Code
WOLFE,ED 01-7042-06 $30.00
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Ill
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Voucher Total $30.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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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
T1032
Wolfe, Edward Purchase Order No.
WWTP Terms
Due Date 12/3/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/3/2014 WOLFE, ED $30.00
hereby certify that the attached invoice(s), or bill(s) is (are)true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date icer