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Home My WebLink About260052 06/28/16 (9, CITY OF CARMEL, INDIANA VENDOR: 364655 ONE CIVIC SQUARE NICHOLAS MISHLER CHECK AMOUNT: $""""""`436.00" CARMEL, INDIANA 46032 1574 OLD MILL CIRCLE CHECK NUMBER: 260052 CARMEL IN 46032 CHECK DATE: 06/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343004 06222016 436.00 TRAVEL PER DIEMS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) NICHOLAS MISHLER ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 1574 OLD MILL CIRCLE IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CARMEL, IN 46032 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $436.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Dept of Community Service Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 6-21-16 43-430.04 $65.00 1 hereby certify that the attached invoice(s),or 6/24/16 6-20-16 Self Park $24.00 1192 101 1192 101 6-22-16 43-430.04 $65.00 bill(s)is(are)true and correct and that the 6/24/16 6-20-16 Per Diem $65.00 1192 101 materials or services itemized thereon for 1192 101 6-23-16 43-430.04 $15.00 6/24/16 6-19-16 Per Diem $65.00 1192 101 which charge is made were ordered and 1192 101 6-19-16 43-430.04 $65.00 received except 6/24/16 6-23-16 Self Park $15.00 1192 101 1192 101 6-20-16 43-430.04 $65.00 6/24/16 6-23-16 Per Diem $65.00 1192 101 1192 101 6-19-16 43-430.04 $24.00 6/24/16 6-21-16 Self Park $24.00 1192 101 1192 101 6-20-16 43-430.04 $24.00 6/24/16 6-19-16 Self Park $24.00 1192 101 Friday, June 24, 2016 1192 101 6-21-16 43-430.04 $24.00 6/24/16 6-22-16 Self Park $24.00 1192 101 1192 101 6-23-16 43-430.04 $65.00 6/24/16 6-21-16 Per Diem $65.00 1192 101 • 1192 101 6-22-16 43-430.04 $24.00 6/24/16 6-22-16 Per Diem $65.00 1192 101 1192 101 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 , 20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer � a CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME:_Nicholas Mishler 155 DEPARTURE DATE: 6/19/2016 TIME: 12:30 PM DEPARTMENT: DOCS- Building &Code RETURN DATE: 6/23/2016 TIME: 20:00 PM REASON FOR TRAVEL: FEMA Flood Conference DESTINATION CITY: Grand Rapids, MI EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM_X Date Transportation Gas/Tolls/ Lodging Meals Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 6/19/16 $24.00 $65.00 $89.00 6/20/16 $24.00 $65.00 $89.00 6/21/16 $24.00 $65.00 $89.00 6/22/16 $24.00 $65.00 $89.00 6/23/16 $15.00 $65.00 $80.00 $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 $0.00 .o0 Totall $0.001 $0.001 $0.00 $111-001 $0.001 $0.001 $0.00 -$0-001 $0.001 $325.00 $0.00�� 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 Signature: Date: City of Carmel Form#ER06 Revision Date 6/24/2016 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$30 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$30 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$65 for out-of-state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of$_130 , 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: 06/Zy/2w City of Carmel Form#ER06 Revision Date 6/24/2016 Page 2 00, rand Rape MI 49684 RAM# : ump 86 nleaded 6 . 825 @ $2 .489/GAL AS TOTAL $15 . 80 AX $0 . fib OTAL . $15 . 88 isa ar d Num XXXXXXXXXXX5758 ERM : 8858882285881. RAMS TYPE : CAPTURE PPR# : 81396D ATCH # " 4. EQ# : , 175884843 MTRY METHOD : ICR 6/83/2816 18 : 58 :45 ', ardho 1 der agrees ay to issuer total,;. harges Per the agreement between:':..`; ardho 1 der & i ssuei .' W.W . SPEEDWAY . COM JW MARRIOTT GL7EST FOLIO GRAND RAPIDS 16 JW Marriott°Grand Rapids•235 Louis Street NW,Grand Rapids,Michigan 49503•616.242.1500•Marriott.com/GRRJW IST-0 MrSHLER/NICK/MR� 154e.00 0& 23/16 12°: 0„ 7384 f 6185 / /^ F l ACCT#,.GROUP_ G�'e tis 19 16 1 .e3 9� 160 n Room - payment - Clerk Address Y ? DATE REFERENCE C�ARGES CREDITS BALANCE DUE 06 19 CASH CK225588i7737 708.40 06/19 OOi �10f 1 2 .00 06/19 CTY TAX 1510, 1 7.70 06/19 STATETAX 1510, 1 9.24 06/19 CVB TAX 1510, 1 6. 16 06/20 GRP ROOM 1510, 1 154.00 06/20 CTY TAX 1510, 1 7.70 06/20 STATETAX 1510, 1 9.24 06 20 CVB TA) 1510 1 6, 16 0 /2%0 SLF PARK O6/21/1 24.00 0621 SLF PARK 06//21 16 24.00 / Gft RSI 1�5i014.UU -- 06- 2-17 CTY- TA-X --- -.-151-0; -1 7.70- --- - — - - ----- - Gt/ft 2i STATETAX 1510, 1 9.24 06 21 CVB TAX 1510 1 6. 16 0 w ARt i / 24.60 6 2 GRP ROOM 1510, 54.00 06/22 CTY TAX 1510, 1 7.70 06/22 STATETAX 1510, 1 9.24 06/22 CVB TAX 1510, 1 6. 16 06/23 VS CARD $96.00 TO BE SETTLED TO: VISA CURRENT BALANCE .00 THANK YOU FOR CHOOSING MARRIOTT! TO EXPEDITE YOUR CHECK-OUT, PLEASE CALL THE FRONT DESK AT EXTENSION 11 011 . AS REQUESTED, A FINAL COPY OF YOUR BILL WILL BE EMAILED TO: NMISHLER@CARMEL. IN.GOV SEE "INTERNET PRIVACY STATEMENT" ON MARRIOTT.COM For questions regarding this folio,please call Marriott Business Services toll free 866.435.7627• To secure your next stay,go tojwmarriott.com C"J