HomeMy WebLinkAbout252008 1 2/02/1 5 Cqq
"F CITY OF CARMEL, INDIANA VENDOR: 00350460
® I ONE CIVIC SQUARE MARK HULETT CHECK AMOUNT: $ ...."775.49'
�. ?a CARMEL, INDIANA 46032 7526 STONEY SIDE LANE CHECK NUMBER: 252008
INDIANAPOLIS IN 46259 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 24721 5 625.00 AHA CTC
1120 4357003 24721 REIMB 150.49 AHA CTC
INVOICE
Mark A. Hulett
7526 Stoney Side Lane
Indianapolis, Indiana. 46259
City of Carmel Invoice#05
One Civic Square Invoice Date: 11-24-2015
Carmel, Indiana.46032 Amount Due: $625.00
ITEM DESCRIPTION UNIT COST QUANTITY LINE TOTAL
Carmel Fire Dept. AHA Community Training Center Coordinator $625.00 1 $625.00
Total: $625.00
Amount Due: $625.00
Terms: $625.00 per month for a total of$7500.00 per year
Notes: This invoice is for the monthly payment of November 2015
6�tr of CA2*,
CITY OF CARMEL Expense Report (required for all travel expenses)
IND IANP
EMPLOYEE NAME: Mark Hulett DEPARTURE DATE: \\ - `o - \S TIME: \ AM PMJ
DEPARTMENT: FIRE RETURN DATE: \\ _\\- \S TIME: 3 AM M
REASON FOR TRAVEL: AHA Scientific Sessions DESTINATION CITY: / Orlando, FL
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT ✓ TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$0.00
11/6/15 $18.83 $18.83
11/7/15 $15.00 10.95 7.38 $33.33
11/8/15 15.06 15.06 9.87 $39.99
11/9/15 15.00 16.17 15.06 $46.23
11/10/15 12.11 $12.11
11/11/15 $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 $0.001 $30.001 $0.001 $0.00 $42.18 $68.44 $9.87 $0.001 $0.00 e
DIRECTOR'S STATEMENT I ereby affirm�that all a enses I ted conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: / Date: No Q 2015
Kim I�Zjv
v '.
City of Carmel Form#ER06 Revision Date 11/30/2015 Page 1
EMBASSY SUITES INT'L DRIVE/JAMAICAN CT
8250 JAMAICAN CT.
ORLANDO,FL 32819
VMHASSY sut'rrs United States of America
},O T V a,S TELEPHONE 407-345-8250 *FAX 407-352-1463
Reservations
www.embassysuites.com or 1 800 EMBASSY
HULETT,MARK Room No: 314/TDBN
Arrival Date: 11/6/2015 6:03:00 PM
MARK HULETT CARMEL Departure Date: 11/11/2015 9:56:00 AM
2 CIVIC SQUARE Adult/Child: 1/0
CARMEL FL 46032 Cashier ID: JESSICA/JESSICA
UNITED STATES OF AMERICA Room Rate: 179.00
AL:
HH#
VAT#
Folio No/Che 584936 A
Confirmation Number:86490736
EMBASSY SUITES INT'L DRIVE/JAMAICAN CT 11/19/2015 4:28:00 PM
DATE IDESCRIPTION ID REF NO CHARGES CREDIT BALANCE
10/27/2015 Advance Deposit CHECK-(number 1383323) STINER 3174956 ($1,006.88)
11/6/2015 RM SVC-Rm Svc Lunch LINTR 3178850 ;x$18.83
11/6/2015 GUEST ROOM AMUNSON 3178928 $179.00
11/6/2015 TAX AMUNSON 3178928 $22.38
11/7/2015 GUEST ROOM AMUNSON 3179279 $179.00
11/7/2015 TAX AMUNSON 3179279 $22.38
11/8/2015 RM SVC-Rm Svc Lunch LINTR 3179552 ✓$15.06
11/8/2015 RM SVC-Rm Svc Lunch LINTR 3179588 t/$15.06
11/8/2015 GUEST ROOM AMUNSON 3179667 $179.00
11/8/2015 TAX AMUNSON 3179667 $22.38
11/9/2015 RM SVC-Rm Svc Lunch LINTR 3179973 15.06
11/9/2015 GUEST ROOM AMUNSON 3180061 $179.00
11/9/2015 TAX AMUNSON 3180061 $22.38
11/10/2015 TELEPHONE-LOCAL LINTR 3180334 $0.75
11/10/2015 LOCAL COMM.SERVICES TAX LINTR 3180334 $0.02
11/10/2015 COUNTY TAX LINTR 3180334 $0.04
11/10/2015 GUEST ROOM MEAGAN 3180448 $179.00
11/10/2015 TAX - MEAGAN 3180448 $22.38
11/11/2015 MEAGAN 3180730 ($64.84)
**BALANCE** $0.00
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2
INVOICE
Mark A. Hulett
7526 Stoney Side Lane
Indianapolis, Indiana. 46259
City of Carmel Invoice#05
One Civic Square Invoice Date: 11-24-2015
Carmel, Indiana.46032 Amount Due:$625.00
ITEM DESCRIPTION UNIT COST QUANTITY LINE TOTAL
Carmel Fire Dept. AHA Community Training Center Coordinator $625.00 1 $625.00
Total: $625.00
I
Amount Due: $625.00
Terms: $625.00 per month for a total of$7500.00 per year
Notes: This invoice is for the monthly payment of November 2015
I�
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))
5 $625.00
Reimbursement $150.49
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mark Hulett
IN SUM OF $
7526 Stoney Side Lane
Indianapolis, IN 46259
$775.49
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 5 43-570.03 $625.00 1 hereby certify that the attached invoice(s), or
1120 43-430.02 $150.49 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
NOV3 U Z015
/pq�fF �Jfa �N FI l;
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund