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250704 10/21/15 CITY OF CARMEL, INDIANA VENDOR: 00350224 ® ONE CIVIC SQUARE NANCY HECK CHECK AMOUNT: S""'1,449.01' :, ra CARMEL, INDIANA 46032 CHECK NUMBER: 250704 ' tro CHECK DATE: 10/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1203 4343003 VEGAS IMLA 1,087.21 TRAVEL & LODGING 1203 4343004 VEGAS IMLA 361.80 TRAVEL PER DIEMS tiA OF CAR 71 R"Nle, IN CITY OF CARMEL Expense Report (required for all travel expenses) ,.N.,I . EXHIBIT A EMPLOYEE NAME: Nancy Heck DEPARTURE DATE: 10/4/2015 TIME:11 : 3 0 AM Al / PM DEPARTMENT: Community Relations & Economic RETURN DATE: 10/8/2015 TIME:7 : 00 AM CPM eve opment REASON FOR TRAVEL: IMLA Conference DESTINATION CITY: Las Vegas, NV 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 revious y 10/4/15 reimbursed $65.62 $256.48 $65.00 $387.10 10/5/15 $41.00 $234.08 $65.00 $340.08 10/6/15 $11.03 $234.08 $65.00 $310.11 10/7/15 $10.84 $234.08 $65.00 $309.92 10/8/15 $65.00 $65.00 $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 $128.49 $0.00 $958.72 $0.00 $0.00 $0.00 $0.00 $325.00 ;1A 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 10/18/2015 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#ERO6 Revision Date 10/18/2015 Page 2 usf olL< S COP'( LAS VEGAS i_IHOIUMES 5010 S. VAL''1'1" VII:W BI-VD. TrarS r�- LAS VEGAS NV, 89118 r'1 DATE: Or- Iu 20f5 \^ TIME: 13:39 VEHICLE: 1?a3_SI:UAN DRIVER#: 81491 JOB #: ?;'8 `, 1!.'j37 Ref 159(1 k) Payment CF;1 UI L NAME: HLCK/Ne1YCY S AMOUNT: "It,. 00 3% tran re ch 16L Airport Fee 6. 00 1 Fuel Fee 3.00 1 SUBTOTAL. 55.62 GRATUITY: 10. 00 TOTAL 65.62 08/18 Approved AUTHORIZATION 0cl1814 SWIPE THANKS FOR YQU11 BUSINESS! TO BOOK REIURN PASSAGE PLEASE CALL 7U7.-888-4848 WNW �.� 10/16/2015 Uber Riders-My Trips U B E R (gNancy - FREE RIDES Filter Trips MY TRIPS Nancy October n3 .... 7204 Las VegasTil Hec,i(- M Trips Ps Pickup Driver Fare Car City Payment Method Profile > 10/07/15 SIVAKUMAR $10.84 uberX Las •••• Vegas UBER HOME CITIES DRIVERS f ® ABOUT US HELP CENTER CAREERS BLOG ENGLISH v https:Hriders.uber.com/tri ps?m onth=2015-10&payment_profi le%5B%5D=487f6443-f02a-4ec4-930a-432e9edagf54&city°/a5B°/a5D=15 1/2 Rio All Suites Hotel & Casino 3700 W. Flamingo Las Vegas, NV 89103 (800)888-1808 (702) 777-7777 Website:www.playrioxom Name: NANCY HECK Room: MT31011 Address: 1326 COOL CREEK DR Arrive: 10/04/15 CARMEL IN 46033 Depart: 10/08/15 U S Persons: I Company Name: ,,Deposit Amt: - — - Convention Code: SRIML5 Reservation ID: 421916146610 Travel Agent No.: Guest Folio ID: 422800917249 DATE REFERENCE DESCRIPTION TKT# S AMOUNT DATE REFERENCE DESCRIPTION TKT# S AMOUNT 10/04/15 422809002523 ROOM CHARGE MT31011 MT31011 209.00 TAX 25.08 10/04/15 422800917250 ADVANCE DEPOSIT 234.08- ************4912 10/04/15 422800917376 ROOM FEES 22.40 EARLY CHECK IN FEE 10/05/15 422819002392 ROOM CHARGE MT31011 MT31011 209.00 TAX 25.08 10/06/15 422829002441 ROOM CHARGE MT31011 MT31011 209.00 TAX 25.08 10/07/15 422839002399 ROOM CHARGE MT31011 MT31011 209.00 TAX 25.08 10/08/15 422841735789 FRONT DESK TOTAL .00 C/O CASHIER LA VERNE GLD RLV Thank y®u f®r staying with us. Guest Signature Page: 1 7/7/ZU 15 0 Southwest Airlines-Purchase Confirmation Espanol ;2iocuthwesto FLIGHT J.HOTELJ CAR SPECIAL OFFERS RAPID REWARDSo S+ westy Thank you for your purchase! Indianapolis,IN-IND to Las Vegas,NV-LAS New Purchases in Trip Air `- Confirmation#84ZTMD 1 Vt7l :, �Qh�(� (�(��J reNm\,U,Tr ed Indianapolis,IN-IND to Las Vegas, 1 NV-LAS ` ccJJJ Sunday,October 4,2015-Thursday, October 8,2015 Air Total:$419.01 Amount Paid '' II ,,I, $419.01 (f't �)�,� Trip Total _ r $419.01 oCT4 suN 10/04/15 - Las Vegas New purchases added to your trip. AIR Indianapolis,IN-IND to Las Vegas,NV-LAS 10/04/2015 - 10/08/2015 Confirmation# 84ZTM D Adult Passenger(s) Rapid.Rewards# NANCY HECK Subscribe to Flight Status Messaging DEPART 11:30 AM Depart Indianapolis,IN Flight southwest* Sunday,October 4,2015 OCT4 (IND)on Southwest Airlines n2540 southwest* SUN_i 12:35 PM Arrive in Las Vegas,NV Travel Time 4 h OS m (LAS) (Nonstop) WiFl available Wanna Get Away RETURN 12:25 PM Depart Las Vegas,NV(LAS) Flight OCT 8 on Southwest Airlines #1151 southwest. Thursday,October 8,2015 THU 1 07:00 PM Arrive in Indianapolis,IN Travel Time 3 h 35 m (IND) (Nonstop) WiR available Wanna Get Away What you need to know to travel- Check-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 haps://www.southwestcom/reservations/confirm-reservations.htmI?disc=sdc%aA1CFF03E541 E54885A7DAC9043E17F996&int= 1/2 n rrcu ra 'jouulwest PJrlines-Purchase Confirmation 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 DING!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. PRICE:ADULT Trip Routing Fare Type I View Fare Rules Fare Details Quantity Total • No Change Fees Depart IND-LAS Wanna GetAway (applicable fare difference applies) raIlert Value Reusable Funds 1 $238.00 (nontransferable-no name changes allowed) • Nonrefundable unless purchased with Points • No Change Fees Return LAS-IND Wanna Get Away (applicable fare difference applies) 5032IlentValue Reusable Funds 1 $181.01 (nontransferable-no name changes allowed) • Nonrefundable unless purchased with Points Enroll In Rapid Rewards and earn at least 2182 Points for this trip. Subtotal $419.01 Already a Member?log in to ensure you are getting the points you Fare Breakdown deserve. Carry-on Items:1 bag+1 small personal item are free,see full details. Checked Items:First and second bags are free,size and weight limits apply. Bag Charge $0.00 Air Total: $419.01 Gov't taxes&fees now included Purchaser Name Nancy Heck Billing Address W. Form of Payment Amount Applied Visa-XXXXXXXXXXXX-4912 $419.01 Amount Paid $419.01 Trip Total $419.01 ©2015 Southwest Airlines Co.All Rights Reserved.Use of the Southwest websites and our Company Information constitutes acceptance of our Terms and Conditions.Privacy Policy https://www.southwestcom/reservafions/corlfirm-reservations.htmI?disc=sdc%3A1CFF03E541 E54885AMAC9043E17F996&int= 212 i International Municipal MYIMLA I J61N Lawyers Association Advancing Excellence in the practice of Loaf Government Law Search... SEARCH UA1/IGATION About iMLA Membership Network Events Legal Advocacy Webinars Archives Publications Job Board Home : Events:Conferences 2015 Annual Conference: Las Vegas;.Nevada IMLA's 80th Annual Conference October 3-7, 2015 Las Vegas, Nevada � C.tO r LA VE G r �, N Welcome News Schedule IMLA Events Registration Sponsors Exhibitors Around Las Vegas Hotel/Lodging Breaking Conference Flews Hotel Information Sleeping Rooms:You will not be disappointed with the sleeping rooms at the Rio!The standard suites are very nice and spacious-600 square feet,conversational lounge area,separate vanity and dressing room,work area and laptop-size safe! The rooms also come equipped with the following: Bedside alarm clock http://www.imia.orgteverds/conferences 1/3 v Vi IIGI GI ILW • Telephone • Hair dryer • iron and ironing board • Make-up and full-length mirrors • Refreshment centers • Laundry services • 24-hour room service • Express in-room checkout • And more! CLICK HERE to see more. Wifi: IMLA attendees will have free wifi in their sleeping rooms. No wifi will be available in IMLA meeting rooms. Rio Hotel Fitness Center.Attendees can gain access to the fitness center by purchasing the Resort Package offered by the hotel: With the resort fee you get 2 "passes" to the gym.They are not tangible passes upon check in but they will check the guests in at the gym making sure they have a resort fee with their room. If a guest does not have a resort fee for some reason then the pricing below will apply. The fitness center is equipped with treadmills, cross-trainers, bikes and a full line of Cybex machines and free weights. Open Gam - 7pm daily; $25 per day charge, $63 for a three day pass, $105 for a five day pass or$125 for a seven day pass.(Hours and fees are subject to change.) Hotel Block Now Open! IMLA has secured a block of sleeping rooms and a special room rate at the Rio All-Suites Hotel & Casino, a first class facility, in Las Vegas, NV.The IMLA room rate is$189 for a single or a double; also these rates are subject to applicable state and local taxes. Reservations may be made by phone or online. Visit the Hotel/Lodging tab for registration information. New!Mobile App: Due to high hotel internet fees, IMLA has been unable to offer wifi in meeting rooms and while this is still the case,we have a great new offer that puts all event information at your fingertips! IMLA introduced a mobile app at the 2015 seminar in Washington, D.C. and will also feature the app at the Annual Conference. IMLA Conference attendees will have the program, speakers, papers, exhibitors,sponsors, maps, attendee list and much much more directly on their iPhone, Android, laptop, tablet, iPad, and/or Blackberry! Stay tuned for updates and more information on these great features! Thoughts or suggestions are welcome! Site Map ?910 inloodnionI Avanue SIiE i 4Y0 - _ail-,ascla Maryland_03t> 202 466 54^_4n r Nebsite by ,EBANLtiei httpi www.imIaorgleverds/conferences 213 Prescribed by State Board of Accounts General Form No.101(1955) MILEAGE CLAIM City of Carmel TO Nancy Heck DR. (Governmental Unit) Dept. of Community Relations & Economic Development On Account of Appropriation No. for (Office,Board,Department or Institution) DATE FROM TO ODOMETER READING* NATURE OF BUSINESS FAMILES MILEAGE@ $ . 575 20 15 Point Point Start Finish ELED PER MILE 4 Home in Carmel Indiana lis Airport IMLA Conference in Las Vegas, NV 32 18 40 10/8 Indianapolis Airport Home in Carmel 32 18 40 It Auto License No. -2TOTALS 64 36 80 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 s me as been paid. Date " 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)) 10/19/15 Mileage Claim $36.80 10/19/15 Expense Report $325.00 10/19/15 Expense Report $958.72 10/19/15 Expense Report $128.49 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Nancy Heck IN SUM OF$ 1326 Cool Creek Drive Carmel, IN 46033 $1,449.01 ON ACCOUNT OF APPROPRIATION FOR Community Relations PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1203 Mileage Claim 43-430.04 $36.80 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1203 Expense Report 43-430.04 $325.00 materials or services itemized thereon for 1203 Expense Report 43-430.03 $958.72 which charge is made were ordered and 1203 Expense Report 43 430.03 $128.49 received except Sunday, October 18, 2015 ALL Director, Community Relations/Economic Development Title Cost distribution ledger classification if claim paid motor vehicle highway fund