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245157 05/13/15 o,gyF. CITY OF CARMEL, INDIANA VENDOR: 354969 J.® ONE CIVIC SQUARE MATTHEW HOFFMAN CHECK AMOUNT: $*****1,025.00* :, _ CARMEL, INDIANA 46032 5808 SEDGEGRASS CROSSING CHECK NUMBER: 245157 vy, CARMEL IN 46033 CHECK DATE: 05/13/15 Rrod c°' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 225.00 EXTERNAL TRAINING TRA 1120 4357004 800.00 EXTERNAL INSTRUCT FEE I iiiii�ll y1111111 I III III III 33 • d Lane Springboro,OH 450661.866.444,4412 Fax: . 1,_• •I www.midamericaosha.org ififo@midamericaosha.org Become an OSHA Trainer! Do you want to be authorized to teach OSHA 10-Hour or '; 30-Hour General Industry courses to your employees? Sign up today for the OSHA 501 and be on your way! - Prerequisites: OSHA 511 Occupational Safety& Health Standards and OSHA 511 -OSHA Standards for 5 years of safety experience in general industry. General Industry: Upon Completion of the course, attendees will receive a CD with sample PowerPoint presentations,OSHA Letters of Interpretation, CFR 1910, Where: Jasper, IN and other tools to use in the classroom! When: 8:00 a.m.to 5:00 p,m. Date: March 10-13,2015 Already a Outreach Trainer for: �,C 1 : Cost: $800 �� w Genera[ Industry and need your F OSHA 501 -Trainer Course in OSHA �yg Standards for General Industry: �� i .Take our 0`SHA 503 and renew your f framer.card for yearn Where: Jasper, IN � When: 8:00 a.m.to 5:00 p.m. 5 OSHA:503 Update'for General y_J ` c 4 Date: April 14- 17,2015 �4 F IN Outreach Trainers _- Cost: $800 i Interested in the Construction Industry? Email us at _ � . info@midamericaosha.org todayRegister online www / II / or email registration form to info@midamericaosha.org, fax 937-704-9394 See reverse side for registration form ©Mid America OSHA Education Center 2008. All rights reserved. rQ"°7nrRLp� ' a CITY OF CARMEL Expense Report (required for all travel expenses) M �NDI.NP EMPLOYEE NAME: Matt Hoffman DEPARTURE DATE: �- \'--�. - TIME: \-SAM/ DEPARTMENT: FIRE RETURN DATE: TIME: AM/ PM REASON FOR TRAVEL: OSHA 501 Trainer Course DESTINATION CITY: Jasper, IN EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air-fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem $0.00 4/13/15 $800.00 $25.00 $825.00 4/14/15 $50.00 $50.00 4/15/15 $50.00 $50.00 4/16/15 $50.00 $50.00 4/17/15 $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 Total $0.001 $0.001 $800.00 $0.001 $0.001 $0.001 $0.001 $0.00 $0.00 $225.00 $0.00 DIRECTOR'S STATEME T: I hereby affirm that all xpens listed conform to the City's travel policy and are within my department's appropriated budget. MAY 1 1 2015 Director Signature: Date: City of Carmel Form#ER06 Revision Date 5/7/2015 Page 1 •e• on ® I 9:11 AM Your payment • Ohio Valley Construct ion... paypal E nt a payment of$800.00 USD to Ohio Mar 27,201513:16:34 PDT Construction Education Foundation. Receipt No:0471-3780-0537-4400 Hello Matthew Hoffman, Cs charge will appear on your credit card statement as payment to PAYPAL*OHIOVALLEYC. Shop with confidence Save time with a PayPal account We keep your financial information secure. Create a PayPal account and save your payment Transactions monitored 24/7 information.You won't need to enter your payment Our fraud specialists help protect your information every time you shop online. account. Sign Up Now You're protected Zero fraud liability for eligible unauthorized purchases.See eligibility Merchant information: Instructions to merchant: Ohio Valley Construction Education None provided Foundation Shipping information Shipping method Not specified Description Unit price Qty Amount OSHA 501 Trainer Course in OSHA Stds.for $800.00 USD 1 $800.00 Gen.Ind.-Jasper,IN USD Total: $800.00 US Receipt No:0471-3780-0537-4400 Please keep this receipt number for future reference.You'll need it if you contact customer service at Ohio Valley Construction Education Foundation or PayPal. -- _. - - --- --- ----- -- -----.._ Help Center Security Center Please don't reply to this email.It'll just confuse the computer that sent It and you won't get a response. Copyright©2015 PayPal,Inc.All rights reserved.PayPal is located at 2211 N.First St.,San Jose,CA 95131. PayPal Email 1D PP1469-468622863c95b 77777---777-7 u' --_th $cZ OSHA 501 - OSHATrainer for General Industry gage i of �j � Training Institute OSM" Education Centers Search ChaWt-las Positas Community Colfcgc District Home Courses Outreach Program Trainer Resources Locations Blog About Us Contact Us Courses > OSHA Train the Trainer > OSHA Trainer Course For General Industry OSHA-501 Trainer Course for General Industry-OSHA 501 - OSHA 501 -Trainer Course for General Industry Course Description: :- This course Is designed for those who are interested in teaching the 10-hour and 30-hour General Industry safety and health outreach Gasses to employees and other interested groups.Special emphasis is placed on those topics that are required in the 10-hour and 30-hour classes as well as on those[hat are the most hazardous in non-construction Industries.Course particlpants learn effective instructional approaches and the successful use of visual aids and handouts.This course authorizes the student to become a trainer in the Outreach Program and to conduct both 10-hour and 30-hour general Industry safety and health courses,and to issue cards to participants verifying course completion. Prerequisites:OSHA 0511 OSHA Standards for General Industry and five years of general industry safety experience.A college degree in occupational safety and health,a Certified Safety Professional(CSP).Certified Industrial Hygienist(CIH)designation may be substituted for tyro(2)years of experience. OSHA#501 Prerequisite Eligibility Form Additional Information A completed oremguisile eligibility fo and a copy of your OSHA#511 course certificate must be submitted prior to the class start date.Prior training experience is recommended before taking this class.Students in OSHA#501 must prepare a presentation on an assigned OSHA general Industry outreach topic and successfully pass a written exam at the end of the course to become an authorized Outreach Trainer.It is highly recommended that you bring a laptop to class to work on developing your presentations. Continuing�Edduucation Units: ®�VJf a -CET /S�� C U BCSP COC Points-3.0 ABIH CM Points-4.34 Safety OTC CEUs-3.0 Registration: 1.Register online and pay by credit card,check or purchase order. 2.Register by mail-Download class registration form. 3.Groups of 6 or morel Call 1-866-936.6742 for a group discount. 4.This class can be taught at your facility.Request an on-site guole. • Our Contact Information In the News Chabot-Las Positas Community College District --- ^��OM1 Preventing Electrical Hazards OSHA Training Center fateb�ok! Why Supervisors on ConstruGion Sites Need Safety Training :7600 Dublin Blvd.,Suite 102A Dublin,CA 94568 OSHA Training Center Gears Un for National Safety Stand-Down Phone:(666)936-6742 h ochoul/Tanout Controls Hazardous Energy and Safeguards Workers Fax:(925)249.9367 OSHA Training Center Offers Dicmuntsl http://oslia4you.com/courses/osha-train-the-trainer/osha-trainer-course-for-general-industry-osha-... 4/28/2015 https://mail.aol.com/webmail-stdien-us/PrintMessage From: mhoffl 9938<mhoff19938 @aol.corn> To: dsnyder<dsnyder @carmel.in.gov> Date: Fri, May 15, 2015 3:53 pm I have sent this about 5 times now and it keeps getting sent back to me. Let me know if you get this... Matt Sent from my Verizon Wireless 4G LTE srnartphone Original message Erom: Mid-America OSHA Education Center &1t;tr'udy@midamericaosha.org> Date: 03/27/2015 4:16 PM (GMT-05:00) To: mhof:19938 @ao.i .r_,om Subject: You have registered for OSHA 501 Trainer Course in OSHA Stds. for Gen. Ind. -- Jasper, IN' OSMN ;t4fr ,44■P keeelilw+aI s,: E��€ire t�Y n-� �� kG �?�a£�'�F�� ;,•, t"0 .1404.01 ,,,wflievowers-p*..istift,ww,4.4srA Matthew Hoffman, You have registered for OSHA 501 Trainer Course in OSHA Stds. for Gen. Ind. - Jasper, IN beginning 04-14-2015 at 08:00 AM -05:00 PM EDT which is held at Jasper, IN - Hampton Inn. The location address is: 55 3rd Ave Jasper, Indiana 47546 United States Your info is: Carmel, Indiana 46033 United States Carmel Fire Department Phone: 3175386893 Email: mhoff19938©aol.com There are 1 people in your group: Your registration price total is $ 800.00. You have paid $ 800.00, which leaves an amount due of$0.00. You paid via PayPal. Your selected login info is: Username: 112819662201 You registered on 03-27-2015 and your status is Active with a payment status of Paid. Confirmation#: OSHA-2139 We are looking forward to seeing you in class! Trudy Matthew Hoffman, You have registered for OSHA 501 Trainer Course in OSHA Stds. for Gen. Ind. - Jasper, IN beginning 04-14-2015 at 08:00 AM - 05:00 PM EDT which is held at Jasper, IN - Hampton Inn. The location address is: 55 3rd Ave Jasper , Indiana 47546 United States Your info is: Carmel, Indiana 46033 United States Carmel Fire Department Phone: 3175386893 1 of 2 5/15/2015 4:01 PM https://mai l.aol.com/webmai I-std/en-us/PrintMessage Email: mhcff19938 @aol.com There are 1 people in your group: Your registration price total is $ 800.00. You have paid $ 800.00, which leaves an amount due of $ 0.00. You paid via PayPal. Your selected login info is: Osername: 112819662201 You registered on 03-27-2015 and your status is Active with a payment status of Paid. Confirmation #: OSHA-2139 We are looking forward to seeing you in class! Trudy 2of2 5/15/20154:01 PM Express ! &suites 04-17-15 Matthew Hoffman Folio No. Room No. 133 5808 Sedgegrass Xing A/R Number Arrival 04-13-15 Carmel IN 46033-8630 Group Code Departure 04-17-15 United States Company LEISURE Conf. No. 65896029 Membership No. PC 230257335 Rate Code : IMGOV Invoice No. Page No. : 1 of 1 Date I Description I Charges I Credits 04-13-15 *Accommodation 89.00 04-13-15 State Tax-Room 7% 6.23 04-13-15 Bed/Occupancy Room 5% 4.45 04-14-15 *Accommodation 89.00 04-14-15 State Tax-Room 7% 6.23 04-14-15 Bed/Occupancy Room 5% 4.45 04-15-15 *Accommodation 89.00 04-15-15 State Tax-Room 7% 6.23 04-15-15 Bed/Occupancy Room 5% 4.45 04-16-15 *Accommodation 89.00 04-16-15 State Tax-Room 7% 6.23 04-16-15 Bed/Occupancy Room 5% 4.45 04-17-15 398.72 Thank you for staying with usl Qualifying points for this stay will automatically be credited to Total 398.72 398.72 your account. Please tell us about your stay by writing a review here-www.ing.com/reviews. We look forward to welcoming you back soon. Balance 0.00 Guest Signature: I have received the goods and/or services in the amount shown heron.I agree that my liablity for this bill is not waived and agree to be held personally liable in the event that the indicated person,company,or associate fails to pay for any part or the full amount of these charges. If a credit card charge, I further agree to perform the obligations set forth in the cardholder's agreement with the issuer. (Owned by K5 investment,LLC and operated by IPD Hospitality Management Inc.) Holiday Inn Express Hotel&Suites Jasper 2000 Hospitality Drive Jasper, In.47546 Telephone:(812)482-3344 Fax: (812)482-3346 L VOUCHER NO. WARRANT NO. ALLOWED 20 Matt Hoffman IN SUM OF$ $1,025.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-430.02 �� 1 hereby certify that the attached invoice(s), or 5 10. 40 ��a.co 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 MAY 1 2015 f) , , I 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) 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 hom, 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)) $1,025.00 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