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252654 1 2/1 5/1 5 ,4Aq a`% CITY OF CARMEL, INDIANA VENDOR: 120950 ® t; ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $*******944.92* �? ��� CARMEL, INDIANA 46032 C/0 DEPT OF LAW CHECK NUMBER: 252654 i�;iTON.�`' C/0 DEPT OF LAW CHECK DATE: 12/15/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343002 353.00 EXTERNAL TRAINING TRA 1180 4343004 250.12 TRAVEL PER DIEMS 1180 4355100 341.80 PROMOTIONAL FUNDS escribed by State Board of Accounts General Form No.101(1955) MILEAGE CLAIM City of Carmel, Indiana TO �, DR. (Governmental Unit) Department of Law - 1180 On Account of Appropriation No. 434-3004 for Mileage Office, Board,Department or Institution) DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @ 7S 20 1,5 Point Point Start Finish TRAVELED PER MILE I rete <tID _I� ' cin IIs 77n ian v11'5 �a I 01'737 37 5 tv hrc 3 0 :3 ,7 D I Auto License No. 1 TOTALS 11 D5 D Q SPEEDOMETER READING columns are to be used only when distance between points cannot be determined.by fixed mileage or official highway map. ursuant 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 lowing all just credits, and that no part of the same has.been paid. ate �I Clcdm No. Warrant No. I have examined the within claim and hereby certify as follows: IN FAVOR OF That it is in proper form; y 105 C t-I G�►'L��l That it is duly authenticated as required by law; That it is based upon statutory authority; �I correct $ C26 v a That it is apparently incorrect l On Account of Appropriation No.4343004 for Disbursing Officer Department of L W - 1180 0 (D AllowedCQ 20 a p in the sum of$ O ( CM, ¢ (4 Na 'gym ¢ (D L �+ g3ocmd or Commission) ` (D 8 rt M FHM U p j (D O �4 ' A 1 (D ((DD I �r gg crn n Y- (Official Title) -` O . ,I i. e V. .1 Not Room 1706 Folio# G _Cashier# 17 CHICA ..F Mattgr4 guy pxa:,,., :Page# 1 of 1 200 North Columbus`Drive Chicago, Illinois,USA 60601 T 312 565 8000 F 312 856 9020 Mr Douglas Haney Arrival 12-05-15 1 Civic Square, City HallDeparture 12-06-15 Carmel IN"46032 United.States :. s. Date Description Additional Information Charges Credits 12-05=15 "Valet Parking" Room# 1706 : 70.00 12-05-15 -Best Available rate 229 00 12-05-15 Room State Tax 27.25 1,2-05-15 Room City Tax .1.0.31 12-06-15 - 336.56 ; Total 336.56 336.56 Balance Due 0.00 Thank you for choosing Fairmont Hotels&Resorts. To provide feedback about your stay please contact the General Manager, at GMCHICAGO@Fairmont.com. We also invite you to share memories of your experience on our community forum-visit www.everyonesanoriginal.com. For information or reservations,visit us at I agree that my flabillty for this bill Is nolwalvad and I agree to be held personally Ilable In the event that the Indicated person,company,travel agent or association fags to pay for the fug amount of the charges.Overdue www.fairmont.com or call Fairmont Hotels&Resorts from: balance subject to a surcharge at t he rate of7.6%per month.(19.66%per annum).All accounts deemed United States or Canada 1 800 4411414 degnquent may be subject to legal fees and all other costs associated with the bill. Account Is payable an presentation or departure. Thank you for choosing to stay with Fairmont Hotels & Resorts HOME . fII70A �offwdl pp l K R Mai re tlaeaun�Screen Transponder History t-Account HoAder°s Name: DOUGLAS HANEY 'Account Number: � Transp®n¢fleu° ED: X5005 €Looking for more report options? Read instructions on Generating Simple Account Reports 2015-DEC : iew selection i ,Detailed Histolry for Month of December 2015 NOTE: This history may contain transactions posted from a prior period. a i Transactions Date/Time Type Amount Agency Location* Plaza Lic Sta Plate 12/05/15 03:25 PM TOLL ($0.18) INDOT Piz -Gary East-Ln 01W - 12/05/15 03:38 PM TOLL ($0.53) INDOT Piz -Westpoint-Ln 01W 12/05/15 03:41 PM TOLL ($4.53) SCC Piz 51-Chicago Skyway Westbound-Ln 01W 51 Transaction ($5.24) Total I* Any lane beginning with a 5 or 6 indicates that the lane is an Open Road Tolling Lane A I-PASS TERMS PRIVACY INFORMATION SECURITY HELP KIDS PRIVACY WEB ACCESSIBILITY CONTACT US t Get Adobe Reader Note: Some links will open in a new window. Copyright©2015 Illinois Tollway Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995) CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Douglas Haney Purchase Order No. One Civic Square Terms Carmel, IN 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same$in accor- dance with IC 5-11-10-1.6. ' 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 glas Haney IN SUM OF $ One Civic Square I Carmel, IN 46032 $ $341.80 ON ACCOUNT OF APPROPRIATION FOR Department of Law 1180 430-55100 Promotion Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), Ilan 42sm on $,141 S or 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 C�S1/VVII�.� 20A 15 l kature YU Cost distribution ledger classification if Title claim paid motor vehicle highway fund rQ, ip CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 12/02/15 11:30 AM DEPARTMENT: Law Department RETURN DATE: 12/04/15 TIME: 5:50 PM REASON FOR TRAVEL: ALI/CLE Seminar DESTINATION CITY: Philadelphia, PA 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 12/3/15 $54.00 $54.00 112/3/15 $88.00 $88.00 12/3/15 $8.00 $8.00 12/4/15 $8.00 $8.00 $0.00 12/2/15 $65.00 $65.00 12/3/15 $65.00 . $65.00 12/4/15 $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 0.00 Total $88.00 $0.00 $16.001 $54.00 $0.00 $0.00 $0:00r $0.001 $0.001 $0.00 $195.00 � 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 Signatu e: Date:! City of Carm F-er ER06 Revision Date 12/7/2015 Page 1 Espanol Southwesto FLIGHT l HOTEL I CAR SPECIAL OFFERS RAPID REWARDS® CL Southwestv Thank you for your purchase! Indianapolis,IN-IND to Philadelphia,PA-PHL New Purchases in Trip Air _ Confirmation#HJWRVV Indianapolis,IN-IND to I Philadelphia,PA-PHL f a Wednesday,December 2,2015-Friday, y December 4,2015 I t � Air Total: $637.01 Amount Paid $637.01 Trip Total $637.01 DEC 2 WED 12/02/15 - Washington D.C. New purchases added to your trip. AIR Indianapolis,IN-IND to Philadelphia,PA-PHL 12/02/2015 - 12/04/2015 Confirmation# H3WRVV Adult Passenger(s) Rapid Rewards# DOUGLAS HANEY I Subscribe to Flight Status Messaging c Travel Datei Flight Segments Flight Summary i DEPART +. 11:30 AM Depart Indianapolis,IN Flight 5aAhweste DEC 2 (IND)on Southwest Airlines #2890 WED ? Wednesday,December 2, --! 01:05 PM Arrive In Atlanta,GA(ATL) 2015 03:55 PM Change�YX to Southwest Flights wesc� Travel Time 6 h 25 m Airlines in Atlanta,GA(ATL) #822 (1 stop,includes 1 plane change) Anytime 05:55 PM Arrive in Philadelphia,PA (PHL) RETURN i 05:50 PM Depart Philadelphia,PA Flight Souttrwgto DEC 4 (PHL)on Southwest Airlines #1252 1 FRI ! ; 08:15 PM Arrive In Atlanta,GA(ATL) Friday,December 4,2015 ._.._....................__.-............................................................................................_............._........... .: 10:55 PM Change s(X to Southwest Flight : Travel Time 6 h 35 m Airlines in Atlanta,GA(ATL) #2216 (1 stop,includes 1 plane change) Anytime 12:25 AM Arrive In Indianapolis,IN Next Day (IND) i 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 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 DINGI 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 • Fully Refundable Depart IND-ATL-PHL Gnyfl bTiy Nu ne-Dae Changes 1 $318.50 • Fully Refundable Return PHL-ATL-IND Anytime m Sae-Day Changes 1 $318.51 hY No Change Fees Subtotal $637.01 Fare Breakdown Carry-on Items:1 bag+1 small personal item are free,see full details. Bag Charge $0.00 Checked Items:First and second bags are free,size and weight limits apply. Air Total: $637.01 Gov't taxes Mees now included Purchaser Name Douglas Haney Billing Address - Carmel,IN US 46033 Form of Payment Amount Applied $549.01 Travel Funds- Original Balance Applied Remaining !!:00 $88.00 $88.00 $0.00 Your Visa credit card ending in ias been added to your MySouthwest account Amount Paid $637.01 Trip Total $637.01 ©2015 Southwest Airlines Co.Ali Rights Reserved.Use of the Southwest websites and our Company Information constitutes acceptance of our Terms and Conditions.Privacy Policy Prescribed by State Board of AccountsACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995) 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 Douglas Haney Purchase Order No. 1 Civic Square Terms Carmel, Indiana 46032 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/7/15 airfareparking, transportation ALI/CLE seminar $353.00 - - - per the attached Total $353.00 1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Douglas Haney IN SUM OF $ 1 Civic Square Carmel, Indiana 46032 $ $353.00 ON ACCOUNT OF APPROPRIATION FOR Department of Law 434-3002 Ext. Training & Travel Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), 1180 4343002 $353.00 or bill(s) is (are) true and correct and that jthe materials or services itemized thereon for which charge is made were ordered and received except i GC°�Y�l ►� 20 aur Cost distribution ledger classification if Title claim paid motor vehicle highway fund