HomeMy WebLinkAbout240687 01/07/15 u Coq
"e. CITY OF CARMEL, INDIANA VENDOR: 366663
d i'r ONE CIVIC SQUARE AMANDA GILLIM CHECK AMOUNT: $ ...-78.05"
4 CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 240687
CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIM 78.05 TRAVEL FEES & EXPENSE
1. Read the instructions on the
2014 BECAUSE KIDS COUNT CONFERENCE back of this form.
2. Print legibly
® December 2-3, 2014 3. Form must be stamped by IYI
®
The
Indianarprior to leaving the conference
Youth 11'1S�Itllt@ (Go to Help Desk for Stamp)
CER;TIF I CATE OF ATTENDANCE 4. Retain the white copy for your
Serving those who impact youth a
records
ATTENDEE INFORMATION
Full NameJ�p y Check the type of credit you need
Check all that apply
OE
Organization ❑❑ DIES— Foster Parents
Mailing Address Z� - ❑ NRPA(Must petition for credit)
❑ NASW
❑ CLE/NLS
City, State, Zip , ^,V „ ` \/&) I f\j q6 ()62— E] LEU
❑ APP
Phone Number los
1 I,7 r_ (aq Ih� ❑ LPC
IQ —G (.,�tlJ _6 D ❑ LSW/LMFT/LCSW/LMHC/LAC
Email Address /l- (01 iryl Gd < <-41� ,Other/Personal Use
WORKSHOP INFORMAtION
MONDAY, DECEMBER 1,2014
1.30pm 5.30pm The Leadership Institute i
TUESDAY, DECEMBER 2, 2014
TIME ACTIVITY TITLE(LIST THE WORKSHOP YOU ATTENDED) ATTENDED HOURS
9:30am-10:30am Opening Plenary featuring Lonise Bias 1.0
Thought S - 1.0
- 11:30am-12:30pnn LeadersI'V/
1:45pm-3:15pm Workshop � 1.5
i i/� 1 �, +1) 1.5
4:00pm-5:30pm Workshop V� R
9:30am-5:30pm The Leadership Institute 8.0
WEDNESDAY, DECEMBER 3, 2014
TIME ACTIVITY TITLE LIST THE WORKSHOP YOU ATTENDED) ATTENDED HOURS
9:30am-10:45am Workshop I�CCQ�s�,'� iC�v�"`^�Z�t^ 1.25
11:15am-12:30pm Workshop Nit) 60P*K e we-�MCt- AN-- 1.25
1 i� —
12:30pm-2:30pm Keynote Luncheon featuring Leigh Anne Tuohy M. 2.0
3:15pm-4:30pm Workshop 1 *Umg 1.25
Total Continuing Education Hours Earned U,
I verify that I attended all of the workshops marked above and that the correct number of CE Hours and/or CRUS are reflected
Attendee Signat e• Date: JE -;5 1
Indiana Youth Institute Stamp
,rs�� ..,;: Date:
yvL➢Vll; Caw"'T yaw BTS
I
Carmel e Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
I Z�Z Qag-L Annogo I I S -3 I , 0 Z ./
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I"L/ Z SvbvUa ..77 13- n e a (c ►`n1c�
.12-13 PGO__An n C) iS 25 , opaizb '�A
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. I TOTAL: $ CRYVED
Employeen Name(print)_4M ot DEC 15 2014
Address 2-1
Check
payable to: City, St,zip--- bnWA�
IV �[lQv(PZ
SCnatur : Approved by:
Date: Date: 22, 1 �
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/8usiness Service Forms/Employee Exp Reimb Request 2007-3
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
366663 Gillim, Amanda Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/5/14 Reimb Travel expenses for Indiana Youth Institute $ 78.05
conference "Because Kids Count"
Mileage 8/5-12/1/14
Total $ 78.05
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
120
Clerk-Treasurer
Voucher No. Warrant No.
366663 Gillim, Amanda Allowed 20
In Sum of$
$ 78.05
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#[TITLE AMOUNT Board Members
Dept#
1081-5 Reimb 4343000 $ 78.05 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
January 2, 2015
Signature
$ 78.05 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund