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HomeMy WebLinkAbout256110 03/04/16 r Fqq a`� '� CITY OF CARMEL, INDIANA VENDOR: 366556 ONE CIVIC SQUARE TIM FAGIN CHECK AMOUNT: $ 292.50 :� �� CARMEL, INDIANA 46032 C/O CFD CHECK NUMBER: 256110 `*�;ioN� CHECK DATE: 03/04/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 030316 292.50 EXTERNAL TRAINING TRA VOUCHER NO. WARRANT NO. ALLOWED 20 Tim Fagin IN SUM OF$ $292.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-430.02 $292.50 1 hereby certify that the attached invoice(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 MAR 9016 \ 1 iV/ Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Hyatt Regency Baltimore ^ � ���� 300 Light Street Baltimore, MD 21202. Tel: 410-528-1234 REGENCY Fax: 410-685-3362 baltimore.hyatt.com INVOICE Payee Tim. Fagin Room No. 0732 . 13434 Spotswood St Arrival 02-23-16 Carmel IN 46032 United States. Departure 02-27-16 Page No. -1 of 1 Confirmation No. 1115134701 Folio Window 1 Group Name EMS Today Conference& Exposition Folio No. 509011 Booking No. 3205QJPR Date Description Charges Credits 02-23-16 Check 255248 716.12 02-23-16 Group Room 155.00. 02-23-16 State Sales Tax 6% 9.30 02-23-16 City Occupancy Tax 9.5% 14.73 02-24-16 Group Room 155.00 02-24-16 State Sales Tax 6%. 9.30 02-24-16 City Occupancy Tax 9.5% 14.73 02-25-16 Group Room 155.00 02-25-16 State Sales Tax 6% 9.30 02-25=16 City Occupancy.Tax,9.5% 14.73 02-26-16 Group Room 155.00 02-26-16 State Sales Tax 6% 9.30 02-26-16 City Occupancy Tax.9.5% 14.73 Total 716.12 716.12 Guest Signature Balance 0.00 I agree that my liability for this bill is not waived and I agree to.be held personally liable.in the event that the indicated WE HOPE YOU ENJOYED YOUR STAY WITH USI person..company or association fails to pay for any part or the full amount of these charges. Thank you for staying with us at the Hyatt Regency Baltimore,we look forward to seeing you again!We are very interested-in hearing about your stay. _.Hyatt Gold Passport Summary Please share your thoughts directly with: No Membership to be credited Aaron McDougle, Director of Rooms aaron.mcdougle@hyatt.com or by mail attn: Join Hyatt Gold Passport today and start Aaron McDougle,300 Light Street,Baltimore, MD 21202 -earning points,for stays, dining and more. Visit ooldpassoort.com For inquiries concerning your bill,please call 888-588-6308 Please remit payment to: Hyatt Regency Baltigiore P.O.Box 842215 Dallas,TX 75284 Snyder, Denise W From: Tunstill, Debbie -The Travel Agent <Debbie.Tunstill@thetravelagentinc.com> Sent: Tuesday,January 26, 2016 00:04 To: Snyder, Denise W Subject: Confirmed Flight for Timothy Fagin SALES PERSON:DT2 ITINERARYANVOICE NO.ITIN DATE:JAN 26 2016 ACCOUNT P90QJ6 PAGE:01 FOR: FAGIN/TIMOTHY D TO: CITY OF CARMEL CITY OF CARME17-'FIRE DEPT ONE CIVIC SQUARE-3RD FLOOR ATTN:DENISE SNYDER CARMEL IN 46032 TWO CIVIC SQUARE CARMEL IN 46032 ----------------------------------------------------------------------- 23 FEB 16-TUESDAY MILES- 515 ELAPSED TIME- 1:40 AIR LV INDIANAPOLIS 730P SOUTHWEST FLT:2721 COACH CLASS CONFIRMED AR BALTIMORE 910P NONSTOP AIRLINE CONFIRMATION:WN-R19RUX 27 FEB 16-SATURDAY MILES- 515 ELAPSED TIME- 1:55 AIR LV BALTIMORE 720P SOUTHWEST FLT:3240 COAGH CLASS CONFIRMED AR INDIANAPOLIS 915P NONSTOP AIRLINE CONFIRMATION:WN-R19RUX THIS IS AN ELECTRONIC TICKET. PLEASE PRESENT PHOTO ID AND CONF NUMBER AT CHECK IN. TICKET IS COMPLETELY NON REFUNDABLE IF UNUSED. MAY CHANGE ONLY PRIOR TO ORIGINAL TRAVEL DATE. FEES MAY APPLY. SOUTHWEST CONF RI9RUX THANK YOU.DEBBIE TUNSTILL 317 805 5762 "VERIFY ALL INFO IS CORRECT.FEES APPLY FOR REISSUES-REFUNDS-CHANGES EMERG.AFTR HRS 877-645-6373 CODE A09$20 PER TRANSACTION A 15PCT FEE OF TOTAL COST APPLIES FOR CANCELLATIONS FOR TERMS AND CONDITIONS SEE WWW.TTA.TRAVEL THIS ITIN MAY BE SUBJECT TO CABIN INSECTICIDE SPRAYING PRIOR TO FLIGHT OR WHILE ON THE AIRCRAFT.FOR REQUIRING COUNTRIES SEE WWW.TZELL41 LCOM LIKE US ON FACEBOOK HTTP://WWW.FACEBOOK.COM/THE-TRAVELAGENTINC AIR TRANSPORTATION 196.98 TAX 42.98 TTL 239.96 PROCESSING FEE 35.00 SUB TOTAL 274.96 CREDIT CARD PAYMENT 274.96- TOTAL AMOUNT 0.00 MYTRIPANDMORE.COM/BAGGAGEDETAIL S WN.BAGG 1 - EMS Lr FEBRUARY 25-27, 2016 TODAlr4d_� Baltimore Convention Center , ' , Tm hitimore, Maryland 111 WEE M�� First Named 1 Last Name 4 WAYS TO REGISTER- JobTitle'9'rtc11mrganization ,11 $ `�� Online: Address 1 + ct t` 2.Email: Address Z Registration@ pennwell.com City Care State/Province 1,-j Postal Code (4603-1, (US°nly)888-299-80 +1-918-831-9161 Country v 5 ' PennWell Registration/EMS Today 201 6� Telephone(+) �� 1 � �'�© 0 Fax(+) ° Box r Dallas, 59, r Email CCrntiIF oy, Your individual email address is required-confirmation is sent via email and is needed for CEH certificate login. If you have multiple licenses or an NREMT#,please contact registration via phone or email. { Certification/License#: 11�1 e 0 IG a 16 License State: I"i Date of Birth; P �y C)1 / �0 1 ` 1 License Type(E.G.,EMT-B,EMT-P)LM-T` P License Category(BLS,ALS,or Other) F "� License Expiration Date: of PROMOCODE* 'Whats this?Promo codes areon direct mail pieces,ernalls atid adveWisements.They are used taprovide . . PLEASEANSWER THE FOLLOWING 1. OCCUPATION/POSITION(CHOOSE ONLY 1) 2.EMPLOYER/AFFILIATION (CHOOSE ONLY 1) 3.PURCHASING ROLE ,XA. Paramedic ❑ 1. Hospital (CHOOSE ALL THAT APPLY) ❑ B. EMT Basic ❑ 2. Private Ambulance ❑ FA Purchase ❑ C. EMT-I,EMT-D 3. Volunteer Fire Dept./Rescue Squad ❑ FB Approve ❑ D. First Responder 4. Paid Fire DeptdRescue Squad ❑ FC Recommend ❑ E. Emergency/Public Safety Manager ❑ 5. Combination Fire Dept/Rescue Squad ❑ FD Specify ❑ F. Physician ❑ 6. Third Service/MuniclpalAgency FE Influence ❑ G. Medical Director ❑ 7. Industrial/Commercial ❑J. Registered Nurse ❑ 8. Educational Institution ❑ K. Instructor/Coordinator/Trainer ❑ 9. Military/Government ❑ L Administrator/Supervisor ❑ 10.other ❑ M.EMS Chief ❑ N. Are Chief ❑ P. Other Chief ❑ R. Pres,Dir,CEO,VP,Mgr 0,S. Captain/Lt/Commander/Other Officer ❑T. Student ❑0. Other(Specify) Pee1T -4, EVENTREGISTRATIOIN . . ICIRG !11,kilill Z Silver Passport(2-Day) ........................................... Early-Bird:$320.......................................Regular:$420 Single Day Full Conference........................................ Early-Bird:$205........................................Regular:$305 Exhibitor Full Conference......................................... Early-Bird:5175.......................................Regular:$175 Exhibit Hall Visitor Only.......................................... Early-Wird:$30........................................Regular:$40 PRE-CONFERENCE o ® . ri . Please select the Pre-Conference Workshop you would like to attend and add the price to your registration total.All are at a first-come,first-served basis.Lunch is included with all 8-hour(full day)workshops and two,4-hour(half day)workshops. Early Bird Rates expire:January 15,2016 WEDNESDAY, FEBRUARY 24, 2016 HALF-DAY WORKSHOPS FULL-DAY WORKSHOPS ❑ Boosting Your Organization's Recruitment,Retention&Reputation Active Shooter Simulation Lab 8:00AM—12:00PM or 1:00PM—5:OOPM 8:00AM—5:00PM Early Bird:S125.00 Regular.S150.00 Early Bird:5215,00 Regular.5240.00 ❑ EMT`Design It Yourself"Refresher Workshop 8:OOAM—12:o0PM or 1:00PM—5:OOPM ❑-6ommunity Paramedicine Preconference Workshop Early Bird:5125.00 Regular.5150.00 8:00AM—5:00PM ❑ NEMSMAs Pressing Topics in EMS Management Early Bird:$215.00 Regular:$240.00 8:OOAM—12:OOPM Early Bird:$125.00 Regular.5150.00 El EMS Compass Town Hall Meeting:How Performance Measures Could Transform EMS S:OOAM—5:00PM ❑Self Defense Tactics for EMS Providers Early Bird:5215.00 Regular:$240.00 8:00AM—12:OOPM or 1:OOPM—5:OOPM Early Bird:$125.00 Regular.5150.00 LUNCH&LEARNS ❑ Cadaver lab 1:00PM—5 OOPM ❑ Medtronic Lunch&Learn Early Bird:$75.00 Regular.575.00 A Critical New Role for EMS in Improving Stroke Outcomes ❑ Emergency Medical Response to the Active Shooter Thursday,February 25,2016 12:OOPM—1:30FM............................Fee:S10 1:00PM—5:00PM Early Bird:$125.00 Regular.5150.00 El Zoll Lunch&Learn Friday,February 26,2016 12:OOPM—1:30PM............................Fee:510 CREW PRICING WARAILITARY PRICING More People = More Savings! Price Early Bird Rate- RegularRate- before 1!15!16 after 1!15!16 Amount of people Price Name of reg type 3-5 $1,000 CODE ALPHA - - f.•. $325 r. $200 $250 6-10 $2,000 CODE BRAVO 11+ $2,500 CODE CHARLIE t 1-Year subscription to JEMS($44 Value) 'y Your registration fee includes a 1-year ; Please ' ' • ' ' of print subscription to JEMS magazine. t e • Along e i iavailable. ❑ Check here if you do not wish to receive JEMS. AR are complimentary. You will not be refunded the subscription rate. TOTAL PAYMENT IDUE METHOD OF PAYMENT Payment must be received prior to conference Please add all selections $ 5 ❑ Check Enclosed(U.S.funds only.Checks payable to PermWell/EMS Today 2016) and total here: ❑Wire Transfer(wiring info provided upon confirmation) ❑Credit Card: PROMO CODE: []Amex ❑Visa ❑MasterCard []Discover ❑Dlners Club Payment must be received by published date to receive early registration discounts. Card Number Cancellations must be received In writing by February 8,2016 to receive a refund minus Exp.Date g 9H* a$75.00 administrative fee.NO REFUNDS will be permitted after February 8,2016. Jame on Card Substitutions may be made at any time by written notification to the registration office. Signature 4i CA6 i�. CITY OF CARMEL Expense Report (required for all travel expenses) V '-/MDIANP EMPLOYEE NAME:Tim Fagin DEPARTURE DATE: '� -�3-�� TIME: AM/ M DEPARTMENT: FIRE RETURN DATE: TIME: AM/_ M REASON FOR TRAVEL: EMS Today Conference DESTINATION CITY: Baltimore, MD EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Meals Date Gas/Tolls/ Lodging Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem $0.00 $0.00 $0.00 $0.00 2/23/16 32.50 $32.50 X2/24/16 65.00 $65.00 2/25/16 65.00 $65.00 2/26/16 65.00 $65.00 2/27/16 65.00 %MWO $0.00 $0.00 $0.00 $0.00 $0.00 .L$0.00 $0.00 $0.00 $0.00 $0.00 0.00 Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $292.50 $0:00 DIRECTOR'S STATEMENT: I er by affirm that all exTe ses list �99�conform to the City's travel policy anDate: � de�rR wdthrp H06partment's appropriated budget. Director Signature: t 0 City of Carmel Form#ER06 Revision Date 3/2/2016 Page 1