247632 07/21/15 o+us C�gyff
CITY OF CARMEL, INDIANA VENDOR: 027850
d ONE CIVIC SQUARE JAMES BRAINARD CHECK AMOUNT: $*****2,270.22*
CARMEL, INDIANA 46032 CHECK NUMBER: 247632
' .o�a�? CHECK DATE: 07/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343001 1,647.05 TRAVEL FEES & EXPENSE
1160 4343003 525.67 TRAVEL & LODGING
1160 4343004 97.50 TRAVEL PER DIEMS
4�`rpnAMF!
CITY OF CARMEL Expense Report (required for all travel expenses)
/NDIANA EXHIBIT A
EMPLOYEE NAME: James Brainard DEPARTURE DATE: 7/15/2015 TIME: 1 : 14 AM/ PM
DEPARTMENT: Mayor RETURN DATE: 7/16/2015 TIME: 9 : 21 AM PM
REASON FOR TRAVEL: City Promotion and DESTINATION CITY: NYC; NY
Economic Development
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
7/15/15 $1,465.20 $32.50 $1,497.70
7/15/15 $12.50 $525.67 $538.17
7/15/15 $10.30 1 $10.30
7/16/15 $123.05 $36.00 $65.00 $224.05
$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 $1,465.20 $0.00 $145-851 $36.001 $525.671 $0.001 $0.001 $0.001 $0.001 $97.501 $0.00
DIRECTOR'S STATEMENT: I ereb 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 7/21/2015 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.
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.
Employee Signature: Date:
City of Carmel Form#ER06 Revision Date 7/21/2015 Page 2
Page 1 of 1
Transaction DetailsPrepared for
d's
James C Brainard Account Number
,DATE DESCRIPTION CARD MEMBER AMOUNT
IJUL142015 UNITED AIRLINES HOUSTON TX JAMES C BRAINARD $1.465.20
I
Doing business as
Flight Details
UNITED ELEC TICKETNG --- -- ---- -
I
600 JEFFERSON ST I INDIANAPOLIS N.Y.NEWARK INTL A
STE 1900
HOUSTON
N.Y.NEWARK INTL A INDIANAPOLIS
TX I
77002-7324
UNITED STATES
Additional Information:19591336 WWW.UNITED.COM I Passenger Name:BRAINARD/JAMESCDR
UNITED AIRLINES ( Date of Departure:07/15
Reference:320151960461276388 Ticket Number:01624568031402
Category:Travel-Airline
Document Type:PASSENGER TICKET
https:Honline.americanexpress.com/myca/shared/summary/estatement/print_doc2015-R3.h... 7/17/2015
Page 1 of 4
U N I T E DConfirmation:
A STAR A�I,iANOE MEMBER v��'
GRNXY6
Check-In>
Issue Date:July 14,2015
Traveler eTicket Number Frequent Flyer Seats
BRAINARD/JAMESCDR 0162456803140 UA-XXXXX224 5C/1 8C
FLIGHT INFORMATION
Day,Date Flight ClassDeparture City and Time Arrival City and Time Aircraft Meal
Wed, UA4352B NEWARK,NJ ERJ-
15JUL15 INDIANAPOLIS,IN (EWR-LIBERTY)3:15 145
(IND)1:14 PM PM
Flight operated by EXPRESSIET AIRLINES INC.doing business as UNITED EXPRESS.
Thu, UA3557B NEWARK,NJ ERJ
16JUL15 (EWR-LIBERTY)7:06 INDIANAPOLIS,IN 170
PM (IND)9:21 PM
Flight operated by SHUTTLE AMERICA AIRLINES doing business as UNITED EXPRESS.
FARE INFORMATION
Fare Breakdown Form of Payment:
Airfare: 1,336.74 USD
September 11th Security 11.20 6001
Fee:
U.S.Passenger Facility 9.00
Charge:
Per Person Total: 1,465.20 USD
eTicket Total: 1,465.20 USD
The airfare you paid on this itinerary totals:1,336.74 USD
The taxes,fees,and surcharges paid total: 128.46 USD
Fare Rules: Additional charges may apply for changes in addition to any fare rules
listed.
NONREF/OVALUAFTDPT/CHGFEE
Cancel reservations before the scheduled departure time or TICKET HAS
NO VALUE.
Baggage allowance and charges for this itinerary.
Baggage fees are per traveler
Origin and destination for checked baggage 1St bag 2nd bag Max wt/dim per piece
7/15/2015 Indianapolis,IN(IND)to Newark, 25.00 35.00 50.Olbs(23.Okg)-62.Oin
NJ EWR-Liberty) USD USD (157.Ocm)
7/16/2015 Newark,NJ(EWR-Liberty)to 25.00 35.00 50.Olbs(23.0kg)-62.Oin
Indianapolis,IN(IND) USD USD (157.Ocm)
MileagePlus Accrual Details
BRAINARD/JAMESCDR
Date Flighi From/To ward PQ PQ PQD
Miles
7/15/2015 4352 Indianapolis,IN(IND)-Newark,NJ(EWR- 3265 966 1.5 653
Liberty)
/16/201 3557 Newark,NJ(EWR-Liberty)-Indianapolis,IN 3425 966 1.5 685
ward PQPQ PQD
Miles
amescdr's MileagePlus Accrual totals: 690 1193213 133
Important Information about MileagePlus Earning
•Accruals vary based on the terms and conditions of the traveler's frequent flyer
program,the traveler's frequent flyer status and the itinerary selected.United
https://maii.aol.com/webmail-std/en-us/suite 7/21/2015
Page 1 of 1
Transaction DetailsPrepared for
,uaeawN James C Brainard
owaess Account Number
F 7
DATE DESCRIPTION v — -- --- — CARD MEMBER � � -- AMOUNT
�JU052015 NEWARK AIRPORT JAMES C BRAINARD $12.50
Doing business as
NEWARK AIRPORT i
ROUTE 1 AND 9 1
NEWARK
NJ
07114
UNITED STATES
CategoryTransportation-Rail Services
TRAINSIT
The Way To Go.
RECEIPT
07/15/15 16:22
NJ TRANSIT Rail
1 ADULT One Way
**EWR** NYP NYP
—SERI-A-L—N R- : 05908
FARE $12. 50
TOTAL $12. 50
PAYMENT Credit-AE
AMOUNT $12.50
MERCHANT 04003570009
TRANS. ID 028-0172113024
ACCT NO
NAME .
AUTH NO _ 569306
357 **EWR**
https:Honline.americanexpress.com/myca/shared/summary/estatement/print_doc20l 5-R3.h... 7/17/2015
Page 1 of 1
dTransaction DetailsPrepared for
nrnFRww James C Brainard
oPREss Account Number
DATE DESCRIPTION CARD MEMBER AMOUNT
'JUL152015 HILTON GARDEN INN JAMES C BRAINARD $604.52
Doing business as. Sometimes businesses like hotels and gas stations place a temporary Charge on your
HILTON GARDEN INN Card,so please check the charge amount after the transaction posts.
39 AVENUE OF THE AMERICAS j
NEWYORK I
NY
i
10013
UNITED STATES
i
Category:Travel-Lodging j
https://online.americanexpress.com/myca/shared/summary/estatement/print_doc20l 5-R3.h... 7/17/2015
Fitton
G�1�/f� � �'A® 39 Avenue of the Americas•New fork,NY 10013
6.� tl tl .l�g Phone(2 12)966-4091 • Fax(212)966-4092
New York City/Triheca Reservations
Name&Address www.Stavl-IGI.com or 1 877 STAY FIG
BRAINARD,JAMES Room 511/Q1DZ
12662 ROYCE CT Arrival Date 7/15/2015 5:27:OOPM
Departure Date 7/16/2015
CARMEL, IN 46033-2477
US Adult/Child 1/0
Room Rate 455.05
RATE PLAN L-PGARP3
HH# 928398206 SILVER
AL:
BONUS AL: CAR:
CONFIRMATION NUMBER: 3189814491
7/16/2015 PAGE 1
DATE DE CRIPTI N ID REP NO CHARGES CREDITS 13ALAN E it
7/15/2015 GUEST ROOM TF1 824654 $455.05
7/15/2015 NY STATE TAX TF1 824654 $40.39
7/15/2015 CITY TAX TF1 824654 $26.73
7/15/2015 OCCUPANCY TAX TF1 824654 $2.00
7/15/2015 JAVITS CENTER FEE TF1 824654 $1.50
WILL BE SETTLED TO $525.67
EFFECTIVE BALANCE OF $0.00
EXP NSE REP RT SUMMARY A
12:00:OOAM STaY TOTAL
ROOM&TA $525.67 $525.67
DAILY T DTAL $525.67 $525.67
Hilton HHonors(R)stays arf posted within 72 hours c f checkout. To chec your
earnings or book your next tay at more tt an 3,900 h te/s and resorts in 1
countries,please visit HHor ors.com.
DATE OF CHARGE POLIO NO/CI-IECK NO
222559 A
Zip-Out Check-Out'
Cood tMorning! We hope you enjoyed your stay.With Zip-Out Check-Out® AUTHORIZATION INITIAL
there is no need to stop at the Front Desk to check out.
• Please review this statement. It is a record of your charges as of late last
PURCHASES&,st:Rvlces
evening.
• I'-ar any charges after your account was prepared,you may: TAxrs
+pay at the time of purchase.
+charge purchases to your account,then stop by the Front Desk fir an
0
updated statement. TIPS R Nllsc
+or request an updated statement be mailed to you within two business days. F_
If the statement meets with your approval. simply press the "Lip-Out Check-Out
TOTAL AMOUNT
button on your guest room tcicphone. Your account will be automatically checked
out and you may use this statement as your receipt. Feel free to leave your key(s) PAYMENT DUE UPON RECIAPT
in the room. Please call the Front Desk if you wish to extend your sary or if you
have an.r questions about your account.
M[:Dw jb'!8
DRIVER: 5138950
07/15/15 TR 558
START END MILES
17:14 17:21 2.1
REGULAR FARE
RATE 1:$ 8.50
EXTRA: $ 1.00
SURCH: $ 0.00
IMSRCH:$ 0.30
TOTAL: $ 10.30
THANKS Cab
10 CONTACT TLC
DIAL 3-1-1
Page 1 of 1
Transaction DetailsPrepared for
d-ar
James C Brainard
Account Number
TE DESCRIPTION CARD MEMBER AMOUNT
iJUL152015 55 STAN OPERATING CORP T JAMES C BRAINARD $123.05
Doing business as
55 STAN OPERATING CORP
4516 VERNON BLVD
LONG ISLAND CITY
NY
11101-5203
UNITED STATES
Category:Transportation-Taxis&Coach
l A�_
-- IF:IGIh;hL--
''1E[:I# 2646
I
C CJ ip1ER is F;i
r.
irt
RH-TE .7:$ 8'F.50
E.-"TRH: $ 1.00
:KIRI H: $ il,sjti
LnTrll: 11.75
H: I:i.Acl
Ir9:F:GH:
0.70
TIP: 20.50
Ti THL: 12.7.05
HAD YPE:
'i TH:515b
11
https-.//online.americanexpress.com/myea/shared/summary/estatement/print_doc2015-R3.h... 7/17/2015
Page 1 of 1
Transaction DetailsPrepared for
uweaww James C Brainard
owaess Account Number
DATE DESCRIPTION CARD MEMBER AMOUNT i
I
IJUL162015 INDIANAPOLIS INTERNATIONAL AIRPORT JAMES C BRAINARD $36.00
Doing business as - --.----—- --- ------ --—— ------------ ---�
INDIANAPOLIS INTERNATIONAL AIRPORT
7800 COL H WEIR COOK MEM
I
STE 38
INDIANAPOLIS
IN
46241-8004
UNITED STATES
Category:Other-Government Services —
Indianapolis International Airport
indianapolissairport.com
RECEIPT
TRAN IN TIME OUT TIME FEE CC#
https://online.americanexpress.com/myca/shared/summary/estatement/print_doc20 l 5-R3.h... 7/17/2015
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))
07/21/15 Expense Report $97.50
07/21/15 Expense Report $525.67
07/21/15 Expense Report $36.00
07/21/15 Expense Report $145.85
07/21/15 Expense Report $1,465.20
1 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
$2,270.22
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 $97.50
bill(s) is (are)true and correct and that the
1160 Expense Report 43-430.03 $525.67
materials or services itemized thereon for
1160 Expense Report 43-430.01 $36.00 which charge is made were ordered and
1160 Expense Report 43-430.01 $145.85 received except
1160 Expense Report 43-430.01 $1,465.20
esday, July 21, 2015
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund