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244256 04/15/15 1 �! ,�, CITY OF CARMEL, INDIANA VENDOR: 120950 ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $*****1,725.70* ,� CARMEL, INDIANA 46032 C!0 DEPT OF LAW CHECK NUMBER: 244256 'M,«oN�. C!0 DEPT OF LAW CHECK DATE: 04/15/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343004 39.10 TRAVEL PER DIEMS 1180 4343002 REIMB 1,686.60 EXTERNAL TRAINING TRA } CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: Douglas Haney DEPARTURE DATE: 03/25/15 5:25 PM DEPARTMENT: Law Department RETURN DATE: 03/28/15 _ TIME: 7:50 PM REASON FOR TRAVEL: ALUCLE Employment Law Seminar DESTINATION CITY: Washington D.C. 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 2/4tt5 $668.00 $668.00 �5��� q•5 $714 $714. $70.00 $70. $6.45 $6.45 $0.00 $0.00 3/25/15 $32.50 3/26/15 $65.00 3/27/15 $65.00 3/28/15 GS $65.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 Total $668.00 $0.00 $6. 5 $70.00 $714. $0.00 $0.00 $0.00, $0.00 $0.00 • DIRECTOR'S STATEMENT: reb affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. _ . Director Signature: �' Date:`/� ), I l I b, 0?©16 City of Carmel Form#ER06 Revision Date 4/6/2015 Page 1 Eapatiol S®UthWestw FLIGHT1 HOTEL l CAR SPECIAL OFFERS RAPID REWARDS® q Indianapolis, IN to Washington (Reagan National), DC Air Total Price: $668.00 ITINERARY DEPART 05:25 PM Depart Indianapolis,IN(IND)on Flight Wednesday,March 25,2015 i MAR 25 Southwest Airlines #352 WEDTravel Time 1 h 30 m 06:55 PM Arrive in Washington(Reagan National),DC(DCA) (Nonstop) WlFlavallable Anytime RETURN 06:00 PM Depart Washington(Reagan Flight MAR 28 National),DC(DCA)on Southwest '•, 0108.5$Ot rt' r Saturday,Mardr 28,2015 i SAT Airlines Travel Time 1 h 50 m 07:50 PM Arrive In Indianapolis,IN(IND) (Nonstop) WIR available i Anytime i — --What you need to know to travel: — Chedc-In:Be sure to arrive at the departure gate with your boarding pass at least 10 minutes before your scheduled departure time.Otherwise,your reserved space may be cancelled and you won't be eligible for denied booking compensation. No Show Policy:If you are not planning to travel on any portion of this itinerary,please cancel your reservation at least 10 minutes prior to scheduled departure of the flight. For tickets purchased on or after May 10,2013 and travel beginning September 13,2013,Customers who fail to cancel reservations for a Wanna Get Away or DINGI fare segment at least ten(10)minutes prior to travel and who do not board the flight will be considered a no show,and all remaining,unused funds on this reservation will be forfeited,including Business Select and Anytime funds. i PRICE ADULT Trip Routing Fare Type I View Fare Rules Fare Details Quantity Total • Fulty Refundable Depart IND-DCA Gr Depart Same-Day eta Eches es 1 $334.00 • Fully Refundable Return DCA-IND Anytime Seme•Day Changes 1 $334.00 r Great RetoWty No Change Fees Subtotal $668.00 Fare Breakdown i You cant find this great fare on any other webstte. Q* Southwest fares are only on southwestaoms. 1St and 2nd Checked Bags Fly Free Bag Charge $0.00 i *Weight and size limits apply. Air Total: ` $668.00,i Purchase your shopping cart... 4'cnlini:. Modify Trip By clicking'Continue',you agree to accept the fare rules and want to continue with this purchase Get$200 Stateent Crediter. maftfirst purchase You Pay Today: $668.00 Earn90,000 Bonus„Points 1 ACredltOnYourStatement:X200.00 Apply Now r Total Aker StatementCmdlt: $468.00 Add a Hotel We'll keep an eye on your cad for you while you shop.Products not confinred until purchase. i Kello g Conference i Search for hotels in Washington(03/25/2015-03/28/2015) y Hotel at Gallaudat... Close To(optional)_— � �Q7/night Center of destination ♦; within 30 miles -- e- Show Only(optionaii Hotei� Chains Sho AB Hotel Chas Find Hotels 3saritathg ---� ------------- View Details — i ! STATE OF INDIANA ) ) SS: COUNTY OF HAMILTON ) AFFIDAVIT I, Douglas C. Haney, Carmel City Attorney, being first duly sworn upon my oath, state that while on City business March 25, 2015 through March 28, 2015, attending the ALI-CLE's `Employment Law" Seminar in Washington, D.C., I expended Six Dollars and Forty Five Cents ($6.45) of my own monies for metro transportation for which I need to be reimbursed. Dated this day of April, 2015. Co .g Haney Subscribed and sworn to before me, the undersigned Notary Public,this L3 day of April, 2015. AMANDA BENNETT - NOTARY PUBLIC,SEAL STATE OF INDIANA RESIDENT OF MARION COUNTY COMMISSION NO.599586 Amanda Bennett,NOTARY PUBLIC MY COMMISSION EXPIRES:1.5.2017 Resident of Marion County, Indiana My Commission Expires: January 5, 2017 [eburs,mrd:r.VbaredWrdatitsValrad%it metro semina 2015.dw-.4/13/15) Waming:Keep this farecard away from magnetic dances and other magnetic strips to minimize a loss of fare value. m, tiz k' t C7 q?1t11ti �WQ}tflOETtf�'3WQ�13M ��s+rye ss 3 l 1� F S � ��Ired�anapolis tternational Airpdrt �'�� `�. indianapoiisair .PC rt:com U f i v u° -r 7 z DoubleTree by Hilton Hotel Washington DC fir, 1515 Rhode Island Avenue,NW,Washington,District of Columbia,20005-5595, USA DOUBLETREE +1-202-232-7000 VY HOLTON' Reservation Confirmation # 82826265 Hotel Stay Information DoubleTree by Hilton Hotel Washington DC Arrival: Wednesday,25 Mar 2015 1515 Rhode Island Avenue, NW Departure: Saturday,28 Mar 2015 Washington,District of Columbia 20005-5595 1 room for 3 nights USA Phone:+1-202-232-7000 Early check-in cannot be guaranteed.Contact the hotel to inquire about early check-in or late check-out.Hotel check-in . , time is 3:00 pm and check-out is at 12:00 pm. Room and Plan Selection Guest Information Room: Guest name: Mr.DOUGLAS HANEY 2 adults Additional Guests: 2 DOUBLE BEDS-NONSMOKING r HHonors#: Price(3 nights x 208.05) 624.15 Address type: Home Taxes 90.50 Address: Room Subtotal 714.66 AAA RATE USA dhaney@carmel.in.gov Total for stay: $714.65 USD Ph ne: 3175712472 mments: On file Request room away from elevator Payment Information Card type: Card number: Expiration: Nov 2015 j Prescribed by State Board of Accounts {MILEAGE CLAIMGeneral Form No.101(1955) 4City of Carmel, Indiana TO J)00QS DR. (Governmental Unit) I Department of Law - 1180 On Account of Appropriation No. 434-3004 for Mileage. Office, Board,Department or Institution) I I DATE FROM TO ODOMETER!READING* NATURE OF BUSINESS AUTO MILES MILEAGE 20J-Cl- Point Point Start Finish TRAVELED PER MILE -Ulb-3199 ' r r-i- - #6 U-5 g8-73 ff 1 13 Oil I A. I i i I I r 1 ti I I i Auto License No. TOTALS I L *SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is.just and correct,that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been paid. I Date I have exarnined the within claim and Claim No. Warrant No. hereby certify as follows: IN FAVOR OF That it is in proper form; tt� � sp--1 That it is duly authenticated as required by law; That it is based upon statutory authority; That it is apparently correct incorrect 1 - i On Account of Appropriation No.4343004 for Disbursing Officer Department of Law — 1180 O Allowed 20 o q- - , Ur in the sum of$ I o (D C m PE !n j N CD@9 o ,r o � (Board or Commission) i 4 \ O � q m FILED (D rt:r Ct R (D c Q (D O (D (D ' (2 (Officicd Title) j off ( H cD SZ. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.199 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 Douglas Haney Purchase Order No. 1 Civic Square Terms Carmel, Indiana 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 4/6/15 ALI/CLE seminar, 3/26/15-3/28/15 Washington D.C. $1,686.61 per the attached . Total $1,686.61 1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Douglas Haney IN SUM OF $ i 1 Civic Square Carmel, Indiana 46032 $ $1,686.6' ON ACCOUNT OF APPROPRIATION FOR Department of Law 434-3002 Ext. Training & Travel Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that --A34300 1.686.6 the materials or services itemized thereon for which charge is made were ordered and received except 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund