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Home My WebLink About240031 12/09/14 i°�'�Qqi, �/ � CITY OF CARMEL, INDIANA VENDOR: 00352774 j ONE CIVIC SQUARE JORDAN KLEINSMITH CHECK AMOUNT: $••""`"`48.17' �; CARMEL, INDIANA 46032 C/O WASTEWATER CHECK NUMBER: 240031 M/roN�, C10 WASTEWATER CHECK DATE: 12/09/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 48.17 OTHER EXPENSES t 1 �OJ�a . ,l. CW(it1FiON : 8F`G ..;G I ND ANAPOL I� I t�ID S AiV'r IIGWNTWfV'S R' EtIIER'.SFGRTS CHECK' 22c? TABLE. SERVER. 5i)47 Cass DATE. 41 f2- CARD CARD TYPE:. ACCT 4o,, x,xkxMkXxXX' EXP,.DATE- XX;X AUTH :Qb 1 0 �ClF,Pt;Pd a l�LElnlSM1T�i` GRATUITY. TDTAL �I6NAT�Fr�- i we.';valu OU- uplh-i.d ' Review Ais an Yelp' F f - Sheeks, Cindy L From: Kleinsmith, Jordan J Sent: Monday, December 15, 2014 10:34 AM To: Sheeks, Cindy L Subject: RE: Reimbursement Cindy, No alcohol was purchased. Thank you, Jordan Kleinsmith -----Original Message----- From: Sheeks, Cindy L Sent: Monday, December 15, 2014 8:42 AM To: Kleinsmith, Jordan J Subject: Reimbursement You received a check for reimbursement in the amount of $34.00. Please .confirm to me in writing no alcohol was purchased as the detailed receipt from Champions was not attached. Cindy Sheeks City of Carmel Finance Manager 317-571-2428 317-571-2410 fax . i f �VpT.Vflw4�l�t I J CITY OF CARMEL Expense Report (required for all travel expenses) +_ EXHIBIT A EMPLOYEE NAME: Jordan Kleinsmith 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 $15.00 115.00 ' 11/20/14 $15.00 $14.17 $29.17 11/21/14 $4.00 $4.00 $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 11 $0.00 $0.00 . 0.00 Total $0.001 $0.00 $0:00 $34.00 ,$0.00 : .,$0.00 $1.4.17 • '$0.001 $0.001 _,$0-.001 40.00 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 11/25/2014 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 followinJ documentation: 1) Conference or course registration follin, if applicable 2) Travel itinerary or car rental agreem6nt, if applicable 3) Original itemized receipts for-all expenses (or affidavits if appropriate), except for meal per diems �which.require hotel receipt) I 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 $60 for outof-state travel I, I' EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: l r I hereby acknowledge receipt of$ , 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 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 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 thIe 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 i r i City of Carmel Form#ER06 Revision Date 11/25/2014 Page 2 I - I 2014 IEA Annual Conference 'Pu r, Registration Form Please copy this form for additional registrations. For more information, visit: indianawea.org/conference Cancellations made after November 14 will be invoiced, .r Jaro�a�v� 1f1 NAME ` Q First-time attendee Q Life Member* EMPLOYER U0041-L �— Q Elected Official" Q Honorary Member* ADDRESS Q Young Professional (<35) Q Tumblebug Q Student CITY "Free conference registration—lunches not included STATE ZIP RE I O N PHONE Me onmembe Member Nonmember EMAIL n ` -0E L ; z� i PQ$2804' r $310�' 'Q$330 C 0$360 Q � 4 .0 • Q 1 Need Wastewater Credits .. • • 0$145 0$175 0$170 0$200 Cert.# Expir, • r k � t 1 y f 0 I Need Drinking Water Credits Cert.# Expir. •• • 0$120 0$150 0$145 0$175 • Q 1 Need Engineering PDHs A F ; j x • 0 $30 0 $30 0 $30 0$30 1. Mail form to: IWEA, 200 S Meridian St., Ste. 410, Indianapolis, IN 46225 �Q�$60` 2. Fax form to: 317.686,2672 INDIANA $ � r��f ,Water TOTAL PO# 3. Scan form and email to: i ;:rr, E vivo n nment aherbertz@indianawea.org r.'= Association 0 Vegetarian 4. Register online S pay by credit card: indianawea.org/conference 0 Gluten-Free Other: 0 Lactose-Free 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 0 Print https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx ll/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: 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 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 Full Conference(does not include lunches or tours tfzx' Friday Lunch—IWEA&WEF Awards $30.00 , . ,any,) Friday Only(does not include lunch or tours) $145.00 Total: $505.00 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 I https://www.registerforeventnow.com/mattisonweb/PaymentOption.aspx 11/7/2014 VOUCHER # 146100 WARRANT# ALLOWED T9971 IN SUM OF $ KLEINSMITH, JORDAN WASTEWATER Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR 'R 1 c Board members I PO# INV# ACCT# AMOUNT Audit Trail Code i KLEINSMITH, 01-7042-06 $48.17 , i I ,j. 1 5I Y .1 tI Voucher Total $48.17 , 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 T9971 KLEINSMITH, JORDAN Purchase Order No. WASTEWATER i Terms Due Date 12/3/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/3/2014 KLEINSMITH $48.17 i i 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 Date Omcer