241194 01/14/15 CITY OF CARMEL, INDIANA VENDOR: 368807
ONE CIVIC SQUARE VERNON PETERSON CHECK AMOUNT: $*******175.00"
?� CARMEL, INDIANA 46032 22880 ANTHONY ROAD CHECK NUMBER: 241 194
9M(roN� CICERO IN 46034 CHECK DATE: 01/14/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4343002 REISSUE 175.00 REISSUE CK 238696
OF C
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Al Peterson DEPARTURE DATE: TIME: AM/ M
DEPARTMENT: FIRE RETURN DATE: TIME: AM/
REASON FOR TRAVEL: Hazard Zone Conference DESTINATION CITY: Notre Dame, Indiana
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$0.00
10/19/14 $25.00 $25.00
10/20/14 $50.00 $50.00
10/21/14 $50.00 $50.00
10/22/14 $50.00 $50.00
$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
Total 1 $0.00 $0.001 $0.001 $0.001 $0.00 $0.00 $0.00 $0.001 $0.00 $175.00 $0.00 1
DIRECTOR'S STATEMENT: ,,aeb- .Vtl-,--,t al%expenses listed conform to the City's travel policy and are within my department's appropriated budget.
-- OCT 2 7 2014.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 10/24/2014 Page 1
Red Roof Inn Mishawaka-Notre Dame
1325 East University Drive Court
Granger,IN 46530 US
RICOPhone: 574-271-4800
® Fax: 574-271-0956
Email: i0629@redroof.com
Printed: 10/22/2014 6:29:32 AM
Folio (Detailed)
Name: BUTTLER JIM Confirmation Number: 282629-3339
Address. 5 CIVIC
CARMEL, IN US
Room: 220 `. Room Type: NS2Q, NON-SMOKING STANDARD 2 QUEEN BEDS
Nights: 3 Guests: 2/0
Rate Plan: GOV Daily Rate: $58.99 + $0.00 Tax GTD: 900 - CASH
Arrival: 10/19/2014 (Sun) Departure: 10/22/2014 (Wed)
Room Rate:
10/19/2014 (Sun) - 10/21/2014 (Tue) $58.99 + $0.00 Tax per night.
Date Code Description Amount Balance
10/1/2014 901 CHECK ($176.97) ($176.97)
10/19/2014 100 ROOM CHARGES $58.99 ($117.98)
10/20/2014 100 ROOM CHARGES $58.99 ($58.99)
10/21/2014 100 ROOM CHARGES $58.99 $0.00
Summary
Room Tax F&B Other CC Cash DB
$176.97 _ $0-00 $0:00 $0.00 $0.00 ($176.97) $0.00
t s btwna- Nchedutes& bign ups kwe 1 a13
Schedtdes Sign Ups 4. fig
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24
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HazardZone �
Management
Confe "C
'`�IReturrt to Las!
Evert 2014 Brunadni Huard Zone AAanagement and Leadership COnfanInre-Noise Dame,IN
Dates: Start lOt20i2014 Enri 1012212014
I'I Location:
Notre Dame,Indiana 46558
Description:
The Bnusaciffs have again elaborated with the beading fire service instructors to host their 5th
Annual Hazard'ZDne Management and Leadership Conference_Please Jain Usil October 20-22,
2014 at the beautiful Notm Dame campus In South Bend.Indiana.
CM to yftm Coarftrance a
Ctk ten slew ggan&mao 1him
This yeafs conference will feature:
•
Laurence(zonules-Authorot@Deep Sureivat-Yom Yves:llftadles,and ytttyr°
• Scott.Peltin-Reused Phoenix FG.AZ Battalion Chief.C_E.O.of TiGNUM and author of'Sink,
Float,or Swim"
• Alan.Nuck,and Jahn Bru acini-Hazar lZone Management
Gordon Graham-Retire CHIP's Captain,Risk Manager.and President of Lodpol
• Terry Garrison-Fire Chief Houston,TX
•
Along with many morel
Instructors-Click bell for vara MAN N m2lgmh
After June 1,2014 regular registration rae of 5145.00
Hotel Accommodations:
When catling the hotels for special rs0es—please moernton that your reservations are for the
"Brufweinf Hazard Zone Conference at;Notts Dame".
Fairfield tum andSuites at NotraVame
Please use the tbllowing:Onk to make-neseruattonsat the Fairfietd:
http:Uc wp arniotLcongsbnodMmnac inMazardzosnel
1220E Angela Blvd
South Bend,IN
(574)234-5510
Apprexbrutte.Dates:
'Standard King $111:00
'Standard Queens$115-00
°King Suites$115.00
Hilton Gardaa Inn South-Band—'Group
V*ftjIe: hfip'dlhittongardersinn3.hition.com
53885 lsnd'iana.933
South Send,IN 46837
(574)232-7700
Approximate Rates:
https://www.bshifter.com/SelectBlueCardConunand.aspx?view=V iewDetail&eventguid=3h809fD... 8/14/2014
RULE CAROP, Invoice
Across the Street Productions
19101 Stone Ridge Drive-Suite A Date �invoi
_
South Bend, Indiana 46637 8/6/2014 12-2294 .
Bill To
tCarmel Fire Department
Denise Snyder
2 Civic Square
Carmel, IN 46032
I
I
I p.0.No. ! Terms Due Date
------------
E _
Hazard Zone Conf i Net 30 91512014
Quantity _ Description Rate Amount
91 Hazard Zane Conference 2014; Buttler, Hoffman, Hensley, _y� 445.00; 4,005.00
Capshaw,Steele, Brandt,Toney, Stindle, Peterson
I '
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Train the Trainer lnvoicrs ruust be paid 44 clays prior to The start of class
I Make Cbecks Payable to: Total
._
Across the Street Prc urtion3
Mine (V4)'273—W2 To.0lir+* f855) 372-5922 Fax( #) ,3-3174 '' to
VOUCHER NO. WARRANT NO.
ALLOWED 20
Al Peterson
IN SUM OF$
$175.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-430.02 $175.00 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
I
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
j Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$175.00
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
20
Clerk-Treasurer