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Home My WebLink About244502 04/21/15 (9, CITY OF CARMEL, INDIANA VENDOR: 00352767 ONE CIVIC SQUARE WILLIAM HOHLT CHECK AMOUNT: $*******392.00* CARMEL, INDIANA 46032 C/O Docs CHECK NUMBER: 244502 C/0 DOCS CHECK DATE: 04/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343003 267.00 TRAVEL & LODGING 1192 4343004 125.00 TRAVEL PER DIEMS y1RYFgpF! . , CITY OF CARMEL Expense Report (required for all travel expenses) x 11=0=' DEPARTURE DATE: 4/12/2015 TIME: Itprn PM RETURN DATE: 4/15/2.015 TIME: 10AM M PM REASON FOR TRAVEL: Training DESTINATION CITY: Michigan City IN. Date Transportation Gas/Tolls/ Lodging Meals Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 4/12/15 $89.00 Spvo 1 � / 4/13/15 $89.00 $50.00 $139.00 4/14/15 $89.00 $5 ,oD w,c�� $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 $0.00 0.00 Total $0.00 $0.00 $0.00 $0.00 $267.00 $0.00 $0.00 $0.00 $0.00 $125.00 $0.00 M 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 4/16/2015 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 $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 $65 for out-of-state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of$ , 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. 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 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. 1 0 Employee Signature: _william hohlt &, Date: 4/16/2015 Travel to Michigan City i for ABM/Training City of Carmel Form#ERO6 Revision Date 4/16/2015 Page 2 01 BLUE CHIP CASINO OP- 777 BLUE CHIP DRIVE PCASINO MICHIGAN CITY, IN 46360 fiO ZI - 51"A For Express Check-Out Dial Guest Services Name. • WILLIAM HOHLT Folio ID.. 421061171524 Arrival Date: 04/12/2015 Address: Departure Date: 04/15/2015 Room No: BC 616 Guests: 1 Group Code: GIA0418 DATE REFERENCE DESCRIPTION $ CHARGES $ BALANCE 04/12/2015 421059000349 ROOM CHARGE BC 616 89.00 04/13/2015 421069000293 ROOM CHARGE BC 616 89.00 04/14/2015 421079000249 ROOM CHARGE BC 616 89.00 04/15/2015 421081186198 FD 267.00- SUMMARY OF CHARGES ROOMS 267.00 .00 Check Out: Page: Please call (888) 879-7711 For Next Reservation or for any Billing Information Thank You For Choosing Blue Chip Casino A it INDIANA ASSOCIATION of ��..•� B�!•,'�®� BUILDING OFFICIALS an International Code Council chapter Q 2015 INDIANA CODE EDUCATION CONFERENCE Registration Packet April 13-16, 2015 Blue Chip Casino and Resort 777 Blue Chip Drive, Michigan City • Education Opportunities • Classroom Instruction J • Code Official Networking • Mfg. Representation • Certification Preparation • CEU Earning Capabilities • Association Meeting ICC uo 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 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 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 04/16/15 Hotel for conference $267.00 04/16/15 2.5 days at a conference $125.00 �. I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. 20 William Hohlt ALLOWED - IN SUM OF$ i c/o One Civic Square Carmel, IN 46032 $392.00 ,y u ON ACCOUNT OF APPROPRIATION FOR Ej 1 Carmel DOCS PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1192 43-430.03 $267.00 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1192 43-430.04 $125.00 materials or services itemized thereon for which charge is made were ordered and received except i j Friday, April 17, 2015 I � Director t Title Cost distribution ledger classification if claim paid motor vehicle highway fund ; t