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242442 02/19/15 CITY OF CARMEL, INDIANA VENDOR: 027850 ® 1 ONE CIVIC SQUARE JAMES BRAINARD CHECK AMOUNT: $*****2,468.80* ,. � CARMEL, INDIANA 46032 CHECK NUMBER: 242442 CHECK DATE: 02/19/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 4343001 569.40 TRAVEL FEES & EXPENSE 1160 4343003 1,574.40 TRAVEL & LODGING 1160 4343004 325.00 TRAVEL PER DIEMS \��of cgNM CITY OF CARMEL Expense Report (required for all travel expenses) R -NDIANA EXHIBIT A EMPLOYEE NAME: Jim Brainard DEPARTURE DATE: 1/19/2015 TIME: 5 : 0 0 AM PM DEPARTMENT: Mayor RETURN DATE: 1/24/2015 TIME: 9 : 3 5 0_/ PM Media Meetings & USCM REASON FOR TRAVEL:- Winter Co ference DESTINATION CITY: Washington, D.C. EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM X Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air-fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem $0.00 1/19/15 $348.20 $32:50 $380.70 1/20/15 $65.00 $65.00 1/21/15 $65.00 $65.00 1/22/15 $65.00 $65.00 1/23/15 $29.00 ,/ - $65.00 $94.00 1/24/15 $95.00 $97.20 $1,574.40 ' $32.50 $1,799.10 $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 $348.20 0.00 $124-.001 $97.201 $1,574.40 $0.00 $0.001 $0.00 $0.00 $325.00 $0.00 DIRECTOR'S STATEMENT: I he by 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 2/19/2015 Page 1 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 $65 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 $32.50 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 $32.50 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 $65 for out-of-state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of$ , 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. 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 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#ER06 Revision Date 2/19/2015 Page 2 Kibbe, Sharon Subject: USCM FLIGHT INFORMATION Start: Mon 1/19/2015 12:00 AM End: Sun 1/25/2015 12:00 AM Show Time As: Free Recurrence: (none) Organizer: Brainard, James C Categories: Travel Required From: brainardjc@aol.com [mailto:brainardjc@aol.com] Sent: Friday, January 16, 2015 3:28 PM To: Kibbe, Sharon Subject: Fwd: Flight reservation (FBADHC) 119JAN15 I IND-DCA I Brainard/James C for schedule -----Original Message----- From: Southwest Airlines <SouthwestAirlines(a-)luv.southwest.com> To: BRAINARDJC <BRAINARDJC(a)AOL.COM> Sent: Fri, Jan 9, 2015 4:59 pm Subject: Flight reservation (FBADHC) 119JAN15 I IND-DCA I Brainard/James C You're all set for your trip! Southwesto My Account I View My Itinerary Online Check In Online Check Flight Status Change Flight SpecialOffers Hotel Offers Car Offers Ready for takeoff! Thanks for choosing Southwest®for your trip!You'll find everything E t:J you need to know about your reservation below. Happy travels! Upcoming Trip: 01/19/15-Washington D.C. AIR Itinerary AIR Confirmation: FBADHC Confirmation Date: 01/9/2015 Passenger(s) Rapid Ticket# Expiration Est. Points Rewards# Earned BRAINARD/JAMES1037393534 5262473115272Jan 9, 1786 C 2016 Rapid Rewards points earned are only estimates Visit your(MySouthwest,Southwest.com or Rapid Rewards)account for the most accurate totals-including A-List&A-List Preferred bonus points. 1 CHECK-IN' Lim us ftke, -9 ONLY Date Right | | Mon Jan 18808 Depart INDIANAPOLIS,|N<|N[0nnSouthwest Airlines at 5:00 PM Arrive inWASHINGTON(REAGAN NAT|ONAL), DC(DCA)otG:35PK8 Travel Time 1 hm35mins Wanna Get Away Sat Jan 242S13 Depart WASHINGTON(REAGANNATkJNAL), Flexibilfty to PaV Later DC(DCA)nnSouthwest Airlines atV7:55AM Arrive inINDIANAPOLIS, |N(|ND)otV9:35 Aux Travel Time 1 hrs4Omins Em up to Wanna Get Away '750 Rapid Rtmds Nth, What you need toknow totravel: p Don't forget tocheck infor your oigm(s)u4hours before your trip on vvmhweut.uomoryour mobile device.This will secure your boarding position unyour flights. " SouthwestAm/nao does not have assigned seats, choose your seat when you board the plane.You will»oassigned oboarding position based vnyour oheoxintime.The earlier you check in,within u4hours m yuu,n|Um.mooamo,youn�mooam� " vwri.TV,and�|a�ovemim,oand ameninovmay vo�and umvu�o�m UM--1V change based onassigned aircraft.Learn more. Remember to6e\nthe gate area ontime and ready tuboard: Gumnteed Low Rates | / ^ oominutes prior mscheduled departure time:Wemay begin boarding as early usoominutes prior myour flight's scheduled departure time.mm encourage all passengers mplan marrive inthe gate area nolater than this time. 14 Car Corn.pames " 10minutes prior mscheduled departure time:All passengers must obtain their boarding passes and uamthe gate area available for boarding atleast 10minutes prior myour flight's scheduled departure time.nnot,Southwest may cancel your reserved space and you will not maeligible for denied Eam Rapid Rewaids Points boarding compensation. * nyou oonot plan mtravel onyour flight:maccordance with Southwest's wo Show Policy,you must notify Southwest atleast 1uminutes prior myour flight's scheduled departure nyou uonot xanmtmve|onmenigmnnm. Book a Car Southwest will cancel your reservation and all funds will uoforfeited. Air Cost: 34820 � Carryon Items: 1 Bag+small personal item are free. See full details. Checked — — — — FU R —--Items: First and second bags fly free.Weight and size limits apply. Fare Rule(s): 5262473115272: NONREF/NONTRANSFERABLE/STANDBY C�i I REQ UPGRADE TO Y. Valid only on Southwest Airlines.All travel involving funds from this j1 `' Confirmation Number must be completed by the expiration date. Unused j1din ace ''7�,,inm travel funds may only be applied toward the purchase of future travel for thei �, ' ryrs,sI� ,�i,l r, individual named on the ticket.Any changes to this itinerary may result in aavw fare increase. Failure to cancel reservations for a Wanna Get Away fare � segment at least 10 minutes prior to travel will result in the forfeiture of all on, '�2or I - ll°we& remaining unused funds. IND WN WAS233.49HLN7PNR WN IND64.19TDNUNNR 297.68 END X_ ZPINDDCA XFIND4.5DCA4.5 AY11.20$IND5.60 DCA5.60 'Sign U P; ! IsS,a Learn About Our CHECCLY-0BIRD Get EarlyBird I''j Boarding Process + Check-In®Details Cost and Payment Summary �t ®AIR-FBADHC I Base Fare $297.68 Payment Information — - - _- — Excise Taxes $ 22.32 Payment Type:Amer Express I® I fi Segment Fee $ 8.00 XXXXXXXXXXX6001 Passenger Facility Charge$ 9.00 Date: Jan 9, 2015 September 11th Security Payment Amount: $348.20 Fee $ 11.20 —----- — — — Total Air Cost $348.20 IAM u tilt � AV f Rapid Rewards °- Fly Southwest To ------ ---_ --�. - ---- = - . Flight Status Alerts International Destinations - - -— �,bb� You can now book travel Stay on your way with flight departure or from select cities to Mexico .4' arrival status via text message or e-mail. g,The Caribbean at Subscribe Now+ southwest.com. Learn More e Useful Tools Know Before You Go Special Travel Check In Online In the Airport Bleeds Early Bird Check-In Baggage Policies Traveling with Children View/Share Itinerary Suggested Airport Arrival Traveling with Pets Change Air Reservation Times Unaccompanied Minors Cancel Air Reservation Security Procedures Baby on Board Check Flight Status Customers of Size Customers with Disabilities 'Flight Status Notification In the Air Book a Car Purchasing and Refunds Book a Hotel Legal Policies & Helpful Information Privacy Policy Customer Service Commitment Contact Us Notice of Incorporated FAQs Terms 3 2/12/2015 American Express US:Manage Your Card Account:Online Statement I am AMER, - Transaction Details Prepared for E„ James C Brainard Account Number $ XXXX-XX)OOC -36001 Date Description Card Member Amount JAN232015 UBER UBER 866-576-1039 CA JAMES C BRAINARD $29.00 Doing business as: UBER 182 HOWARD ST #8 SAN FRANCISCO CA 94105-1611 UNITED STATES Additional Information:FHB2Y96 8665761039 8665761039 Reference:320150240742270963 Category:Transportation-Taxis&Coach https://online.americanexpress.com/myca/shared/summary/estatement/print doc.html 1/1 Kibbe, Sharon From: brainardjc@aol.com Sent: Friday, January 23, 2015 7:17 PM To: Kibbe, Sharon Subject: Fwd: Your Friday afternoon trip with Uber Sent from my iPhone Begin forwarded message: From: Uber Receipts <receipts.washington.DCna,uber.com> Date: January 23, 2015 at 4:23:48 PM EST To: Brainardic a,aol.com Subject: Your Friday afternoon trip with Uber — ------ JANUARY 23.2015 $29.00 Thanks for choosin',1 FARE BREAKDOWN i2o''\ \ -Was "gton295 - �Arlingi6n-- Base Fare \ ti;120 U >t iiley;s' Distance Broads .: �� . Hillcrest aoroMac Heights Map data©2015' Google Time 04:08pm 1026 16th Street Northwest,Washington,DC Subtotal 04:23pm Ronald Reagan Washington National Airport,2400 South Rounding Down Smith Boulevard,Arlington,VA CAR MILES TRIP TIME BLACK CAR 4.85 00:14:53 1 CHARGED Q"'ersonal ....6001 YOU'VE EARNED 2X POINTS MEMBERSHIP REWARDS® RAIrY(WP DRIVER [Ell You rode with Bob Issued by Drinnen on behalf of Bob's Limousine Service P Uber Support Contact us with tluestiunS about your trip. �I Give $20, Get $20 Leave soniethin-,behind?Track it down. J ._ Share code:8,-All FFr- 2 2/12/2015 American Express US:Manage Your Card Account:Online Statement aMR Transaction Details Prepared for James C Brainard Account Number ° XXXX-XXXXXX-36001 Date Description Card Member Amount JAN242015 UBER UBER 866-576-1039 CA JAMES C BRAINARD $95.00 Doing business as: UBER 182 HOWARD ST #8 SAN FRANCISCO CA 94105-1611 UNITED STATES Additional Information:86T53Q6 8665761039 8665761039 Reference:320150240742296240 Category:Transportation-Taxis&Coach https://online.americanexpress.com/mycalshared/summary/estatement/print_doc.htmI 1/1 THE CAPITAL HILTON 1001 16TH STREET NW WASHINGTON,DC 20036 United States of America Capital Hilton TELEPHONE 202-393-1000•FAX 202-639-5784 Reservations www.hilton.com or 1 800 HILTONS BRAINARD,JAMES Room No: 1044/D2T 12662 ROYCE CT Arrival Date: 1/19/2015 CARMEL, IN 460332477 Departure Date: 1/24/2015 UNITED STATES OF AMERICA Adult/Child: 1/0 Cashier ID:ABIELAWSKA HH# 928398206 SILVER Confirmation Number:3159104368 FOLIO: 1207131A BRAINARD/JAMES THE CAPITAL HILTON 2/17/2015 12:21 Invoice DATE I DESCRIPTION CHARGES 1/19/2015 GUEST ROOM $275.00 1/19/2015 ROOM TAX $39.88 1/20/2015 GUEST ROOM $275.00 1/20/2015 ROOM TAX $39.88 1/21/2015 GUEST ROOM $275.00 1/21/2015 ROOM TAX $39.88 1/22/2015 GUEST ROOM $275.00 1/22/2015 ROOM TAX $39.88 1/23/2015 GUEST ROOM $275.00 1/23/2015 ROOM TAX $39.88 1/24/2015 AX*6001 ($1,574.40) THANK YOU FOR STAYING WITH US AT THE CAPITAL HILTON. Grand Total: $0.00 2/12/2015 American Express US:Manage Your Card Account:Online Statement , SER, , Transaction Details Prepared for Ess James C Brainard Account Number s. XXXX-XX)O(XX-36001 Date Description Card Member Amount JAN 25 2015 CAPITAL HILTON 9910 WASHINGTON JAMES C BRAINARD $1,718.76 DC Doing business as: Itinerary Details HILTON 1001 16TH ST NW I Arrival WASHINGTON 01/19/15 i DC 20036-5794 Departure f UNITED STATES 1 01/24/15 Additional Information:0001975871 (202)393-1000 Reference:320150250758063845 Category:Travel-Lodging LODGING I I (202)393-1000 https://online.americanexpress.com/myca/shared/summary/estatement/print doc.html 1/1 2/12/2015 American Express US:Manage Your Card Account:Online Statement epi Transaction Details Prepared for James C Brainard Account Number XXXX-XXXXXX-36001 Date Description Card Member Amount INDIANAOPOLIS AIRP 51NDIANAPOLIS JAN282015 JAMES C BRAINARD $162.00 IN Doing business as: Transaction Details INDIANAPOLIS AIRPORT AUTHORITY Description Price 7800 COL H WEIR COOK MEM AUTO $162.00 STE 38 PARKING � INDIANAPOLIS LOTS A IN `Abovp� _\- rte. 1r\c—Wk&ed 46241-8004 ,Q do A IS UNITED STATES `^� Additional Information: 128544175 3174879594 3174879594 Reference:320150290821412943 Category:Other-Government Services , https://online.americanexpress.com/myca/shared/summary/estatement/print_doc.html 1/1 i Kibbe, Sharon Subject: USCM Registration Confirmation 1/21 - 1/23 Location: Washington DC Start: Wed 1/21/2015 12:00 AM End: Sat 1/24/2015 12:00 AM Show Time As: Free Recurrence: (none) Organizer: Brainard, James C Categories: Important From: Brainard, James C Sent: Thursday, December 04, 2014 11:41 AM To: Kibbe, Sharon Subject: Fwd: Here is a receipt and hotel form Sent from my iPhone Begin forwarded message: From:Amy Gorman <agorman@usmayors.org> Date: December 4, 2014 at 7:36:52 AM PST To:<Ibrainard@carmel.in.gov> Subject: Here is a receipt and hotel form 319 JAMES BRAINARD Mayor City of Carmel 1 Civic Square Carmel, IN 46032 Phone: 3175712401 ibrainard(@carmel.in.00v REGISTRATION INFORMATION Confirmation Number: 15Winter67602 Registration Date/Time: 12/4/2014 10:11:48 AM Registration Type: MayorMember Badge Name: Jim First Time?: No Special Needs?: N Payment Amoun . $625 Payment Method: reditCard �Dr 1 i Paid?: Yes 'HOTEL REQUEST INFORMATION No hotel rooms have been requested. Amy Gorman Meetings Specialist U.S. Conference of Mayors 1620 I Street, NW Washington, DC 20006 202/293-7330 (main) 202/861-6749 (direct) 202/223-9540 (fax) http://www.usmayors.or z SII Prescribed by State Board of Accounts City Form No.201 (Rev.1995) j� 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 I Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 02/19/15 Expense Report $325.00 02/19/15 Expense Report $1,574.00 02/19/15 Expense Report $124.00 02/19/15 Expense Report $348.20 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 , 20- Clerk-Treasurer 20Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Mayor Jim Brainard IN SUM OF $ One Civic Square Carmel, IN 46032 Mu ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members I hereby certify that the attached invoice(s), or 1160 Expense Report 43-430.04 $325.00✓ � _ ✓ bill(s) is (are)true and correct and that the 1160 Expense Report 43-430.03 $1,574.00 materials or services itemized thereon for 1160 1 Expense Report 43-430.01 $124.00,V which charge is made were ordered and 1160 Expense Report 43-430.01 $348.20 v received except 4?bv Thursday, February 19, 2015 Mayor Title Cost distribution ledger classification if claim paid motor vehicle highway fund