HomeMy WebLinkAbout326002 06/08/18 W.�Qq
a`� '� CITY OF CARMEL, INDIANA VENDOR: 355466
ONE CIVIC SQUARE KEITH FREER CHECK AMOUNT: $*******707.12*
$9` �_� CARMEL, INDIANA 46032 1413 N.FAIRVIEW STREET CHECK NUMBER: 326002
y,�*oN�. ALEXANDRIA IN 46001 CHECK DATE: 06/08/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 0 33.86 GASOLINE
1120 4343002 0 673.26 EXTERNAL TRAINING TRA
, r
INDIANAPOLIS
INTERNATIONAL
AIRPORT
L/R #45 A Payment No.00052860
T/D #38 Ticket No.011368
Entry Time 05/03/2018 (Thu) 6:01
Exit Time 05/06/2018 (Sun) 19:11
Parking Time-- --— ---Mays-1-3:1 0- -
Parking Fee Rate F $36.00
VISA
Account # *****************6579
Slip # 57742
Auth Code 000004678D
Credit Card Amount $36.00
Total $36.00
Thank you, Have a nice day!
(317) 487-5017
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
VOUCHER NO. WARRANT NO.
Vendor# 355466 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
KEITH FREER IN SUM OF$ CITY OF CARMEL
1413 N. FAI RVI EW STREET 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.
ALEXANDRIA, IN 46001
Payee
$707.12
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire 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
0 43-430.02 $673.26 1 hereby certify that the attached invoice(s),or 6/4/18 0 $673.26
1120 101 1120 101
0 42-314.00 $33.86 bill(s)is(are)true and correct and that the 6/4/18 0 $33.86
1120 101 materials or services itemized thereon for 1120 1 101
which charge is made were ordered and
received except
Tuesday,June 05,2018
David Haboush
Fire Chief
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
Of C4AV-
rA.12n
CITY OF CARMEL Expense Report (required for all travel expenses)
NDIANp
EMPLOYEE NAME: Keith Freer DEPARTURE DATE: , — —�� TIME: (AM
>M
DEPARTMENT: FIRE RETURN DATE: TIME: AM M
REASON FOR TRAVEL: Fire& Life Safety Conference DESTINATION CITY: Montour Falls, NY V
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
5/3/18 $105.09 $65.00 $170.09
5/4/18 $65.00 $65.00
5/5/18 $65.00 $65.00
5/6/18 $272.17 $69.86 $65.00 $407.03
$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
Total 1 $0.001 $272.171 $0.00 $69.861 $106.091 $0.00 $0.001 $0.001 so.w 1 $260.001 $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 6/4/2018 Page 1
1IFire ® �" Registration Form
RATE
R nt"i Fire Acaderny.and.Regional Technical Rescue
and ControiNew York State Academy.of Fire.Science
600 College Ave.,Montour Falls,.NY 14865-9634
(607)535-7136;Fax:(607)535-4841
Personal Information Sponsoring Organization
NAME.(Last,First,MI) FIRE DEPARTMENT ID# COUNTY
fiPlc�a1
�
TRAINING IDENTIFICATION'NUMBER SPONSORING ORGANIZATION
HOME ADDRESS(Street,POBox) STREETADDRESS,PO BOX
H13 ,�/ Fiji% �� CMIC sQ✓-e?5
CITY ST TEZIP CITY STATE ZIP
FD PHONE# FD E-MAIL or FAX
. - ZG'-'�
❑ CHECK IF NEW ADDRESS �MALE ❑ FEMALE 317 �/ _s1.7-s7/'G
NAME/TITLE-HEAD OF THE SPONSORING AGENCY
DAYTIME PHONE EVENING PHONE ` �,"pca3„s;'�1n \�.� ��x
/a��� — % SIGN U E- D O .THE E SP N ORING ENCY
FAX# E-MAILADDRESS / 1 ` �'J -4.
�JQ"FIRE ACADEMY COURSE CODE# COURSE TITLE DATES:
01-10-0012 Fire and Life Safety Educators' Conference. May 4 - 6, 2018.
Course Registration - Registration, Material-and Accommodations Fees:
NOTE: Payment MUST Accompany-Registration
Registration Fee is MANDATORYAND NONREFUNDABLE Registration Fee (include w/registration) $ G�
❑ NYS Resident-$25 Out-of State-$50 Materials Fee(if applicable—payable upon arrival) $ $5
Materials Fee (if applicable) payable upon arrival Accommodations-Fee(payable-upon-arrival)
t—
See course description(may not include required text book) Optional commuter dinner(s) $
❑:Prerequisite Proof(if applicable) Total enclosed: $
Must accompany.registration
Balance due upon arrival: s ;.J
Academy Accommodations -payable upon arrival
Resident—includes Meals&Lodging -$84. Reasonable accommodation request:
❑ Commuter—includes breakfast Munch -$.20
❑ Commuter dinner-$9/day (optional) Share-room with:
Payment Method
Make checks, money"orders& vouchers:payable to: ❑ VISA Q.MasterCard ❑ Discover Total Charge: $
Academy of Fire Science ❑�❑� �❑❑� ❑❑a❑ ��❑�
E3 Check ,❑L7,,/Money Order Card#
❑ Signed Voucher Purchase Order Expiration Date[][]/[][] Security Code[][][]
O Bill Meals& Lodging to Student Q..Bill Meals.& Lodging
to Sponsoring Organization Signature
Please review the application to make certain it is complete and the required payment and-prerequisite proof are enclosed.
This form is on the web at.www.dhses.ny.aov/ofoc • MAIL OR FAX APPLICATION TO FIRE ACADEMY.ONLY
NOTE:Due to participant demand,.the deadline for all Academy course registrations is 20 days before the course start"date.if your registration
is not received by this deadline, we cannot guarantee placement in the.requested course. Call the Academy for further information.
1220(10/08)
45111 Annual
Fire and Life Safety Educators' Conference
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PR[YLrHT _..`L3 TO F1 RE
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May 4 - 6, 2018
fNEOK Fire Prevention �Y~ :�, ~TATE and Control Academy Academy of Fire Science
Montour Falls, NY
45111 Annual
Fire and Life Safety Educators' Conference
SCHEDULE
Friday May 4,2018
1100-2:00 Check in for attendees
2:00-2:20 Opening Remarks-Bob Furman-OFPC
2:20-4:00 Teen Talk-School Presentations Cayuga/Onondaga BOCES, Odessa-Montour/Watkins HS,Syracuse HS
4:00-4:15 Break
4:15-5:30 Fire Safety Through History-Part 2-Tim Kelly-Princeton FD, Massachusetts
5:30-10:00 Dinner and Ice Breaker-Cafeteria
Saturday May 5, 2018
8:00-10:00 Opening Remarks-Bob Furman-OFPC, NYSAFC
Keynote Speaker-Donna Forgy-"We Work Way Too Hard as Instructors"
10:00—10:30 Break
10:00-2:00 Vendor Fair/Trade Show in Chapel
Time Auditorium (250) Classroom 4(48) Classroom 5 (48) Classroom 8 (48)
10:30-11:20 fife's not a Game,Sauin
ne can be-SherriW6
uerrer0/Matt Kosak
estminster FD,C•
11:20-12:10 Lunch (Groups green and red)
12:10-1:00 Lunch (Groups yellow and blue)
1:00-1:50 Partnering to Improve Safety for People with I/DD-Robert Crandall/Molly Clifford/Julia Engstrom -
Auditorium
1:50-2:05 Break
2:05-2:55 MEN,P...Change of Fir
reuention...Thin
•utside the Box-Putt.
•outure
2:55-3:10 Break
Time Auditorium(250) Classroom 4(48) Classroom 5 (48) Classroom 8 (48)
3:10-4:00 i _ ga
Malley
are StateFi
4:00—4:15 Break
4:15-5:05 Mal line in th
and on Home FirNPILe
-atalities-Neal Zipser
idd
5:05-5:30 PS Led Networkim
5:30-11:00 BBQ-NYSAFC
Sunday May 6, 2018
8:00-8:50 ome Safety Journey t
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8:50-9:05 Break
9:05-9:55 ire Science an04o,y
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onica Colby/Tim
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9:55-10:10 Break
10:10-11:00 lay Safel Be Safe! Fo
Young Children-IVlolf
Clifford"--
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11:00-11:15 Break
11:15-12:05 unrot Fire,/ACademy`
'-h�teha_II FD _Jame-
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P&
HOME Please Drive Safely-Thank You
Keynote
Donna Forgy— We Work Way Too Hard as Instructors
At the end of an 8-hour or even 4-hour class room day are you physically and emotionally drained? Did
you spend most of the day lecturing and spitting slides out to keep.your audience engaged? Did you
notice that the participants were just warm bodies taking up a seat?
Research supports that most learning occurs in group exercises. There are methods that increase
both the quality and quantity of student involvement. Not to mention the fact that there is a direct
correlating between "fun" and "learning". There are some easily understood common sense
techniques that will engage even the "dead beat" students.
General Session
Robert Crandall —Partnering to Improve Safety for People With I/DD
People with intellectual and developmental disabilities (I/DD) are at increased risk of injury and death
in residential fires. Experts from the fire service and disabilities agencies worked together to develop
the "Safe at Home" program, which looks at both environmental factors and safety skills to improve
the safety of people with I/DD who live independently. Together, they built a replicable model that has
shown success in helping people with I/DD know what to do to prevent fires and how to escape them
safely. This presentation will introduce the program design and content, describe its successes and
challenges, and outline the steps you can take to identify partners and bring "Safe at Home" to your
community.
Breakout Sessions
Sherrie Guerrero—Life's Not a Game, Saving One Can Be!
Learning fire and injury prevention through games is fun and interactive way to engage kids to learn.
I've created TV show games for the past 10 years for our 3rd grade program for Fire Prevention Month,
the games are based on the State of Colorado curriculum.iHere are some of the games I've created,
Deal or No Deal, Fire Safety Bingo, Are you Smarter than a Firefighter, Firefighter Feud, The Price is
Life, Westminster Fire Brain Drain... and so on. The games can be created on a low budget with one
Public Educator.
Molly Clifford —Play safe!Be safe!For Young Children
This workshop will review the surprising frequency of young children's misuse of fire, present sound
strategies to educate and motivate children and families to change their behavior toward fire and fire
safety, and encourage the adoption well regarded safety practices. All participants will receive a play
safe! be safe! kit at no cost for use in their outreach efforts. The workshop will cover how best to use
the kit and the on-line activities at www.playsafebesafe.com and information on how communities can
obtain additional materials.
Becky Booker—Home Safety:A Journey to the UK and Beyond For Answers
This is one person's journey in the fire service to make an impact on fires in the,US. No longer can
we accept the number of fire deaths of residents and firefighters without considering changing the
direction of some of our priorities. Come on a quest that starts with 20 years of experience doing fire
prevention in the homes and follow along to England to find the secrets of their amazing success in
turning the numbers of fires around in their country. You will be given all the tools to create a home
safety survey. Then watch things change!
Neal Zipser—Drawing a line in the Sand on Home Fire Fatalities
The presentation examines the home fire fatalities issue nationally and in New York state and the
problem of non-working smoke alarms. We look at why alarms fails, what can be done to increase the
number of working alarms,where they should be installed and the latest alarm technologies, including
10-year sealed batteries and wireless interconnected alarms. Presentation moves fast and includes
several videos.
Monica Colby/Tim Behlings —Fire Science and Our Messaging:Are We Keeping Up?
We know that fire moves faster in a building than ever before due to our furnishings but do you know
what is really happening during a fire? Given the speed of fire and smoke, are our messages about
escaping a fire still relevant? How do we prevent all fires and is that possible through education
alone? The placement of home smoke alarms has changed, do you know where they can be placed
on the ceiling? Discuss these concerns,fire flow, and smoke production and take today's scientific
understanding of fire and hold our common fire safety messages up for examination. Students will
leave with a better understanding of how fire prevention education and engineering work hand in hand
to mitigate the impact of fire.
Patty Couture—Be the Change of Fire Prevention...Think Outside the Box
Think outside the traditional box of Fire Prevention. Let's explore a new approach to how we present
and who we present to. Doing the traditional teaching to our school age children is still essential, but
there are many more groups that need to be reached. Our senior citizens need more information now
that many are living alone. Home health agencies, college students and the general public are other
target audiences.
Whitehall Fire Department—Junior Fire Academy
This all-day specialty camp is designed for children entering 4th through 8th grade, and is taught by
Whitehall Volunteer Fire Company firefighters, state certified fire instructors and EMT's in topics such
as: Fire cause and Prevention, Fire Safety, Firefighting equipment and its usage, CPR and First Aid,
Importance of Teamwork, Physical fitness and Marching just to name a few.
The Junior Firefighter Academy, often referred to as fire camp, is offered Monday through Friday the
first week of August and will conclude with a formal graduation ceremony on the following Saturday.
Classes begin at 9am and will end at 3pm each day. Fire camp focuses on development of the four
core character values of Caring, Honesty, Respect and Responsibility.
As a Junior Firefighter, each child will hold an important role in the Fire Safety of their families, school
and fellow classmates. the fire camp was created as a new approach to our Fire Prevention Education
program.
F. =,
Hampton Inn Cortland May. 03, 201804, 2018
• River Street, • • NY 13045 • • •- 86334776
607-662-0007 PDA
TEr
Shawnda Freer,
see you on May 03, 2018 EXPLORE
Neighborhood
Your Room Information: Your Plan Information:
2 QUEEN BEDS NONSMOKING ALTERNATE GOVERNMENT
Rooms: 1 Rate per night : 93.00 USD
Guests: 1 Adult Total for Stay per Room
Check In: May 03 3:00 PM Rate: 93.00 USD
Check Out: May 04 11:00 AM Taxes: 12.09 USD
Total: 105.09 USD
Free Cancellation:If your plans
change, let us know by May 01 to Total for Stay : 105.09 USD
avoid being charged for the first
night.
Freer, Keith T
From: Delta Air Lines <DeltaAirLines@e.delta.com>
Sent: Tuesday,January 30, 2018 7:59 PM
To: Freer, Keith T
Subject: Your Flight Receipt- KEITH FREER 03MAY18
Your Trip Confirmation#:JAB55C '
Thu;03MAY DEPART ARRIVE-.
DELTA 3704* INDIANAPOLIS,IN DETROIT
Basic Economy(E) 8:00am 9:20am
DELTA 6216* DETROIT ELMIRA, NY
Basic Economy(E) 10:00am 11:14am
77
Sun,.06MAY `DEPART ARRIVE; .
DELTA 6253* ELMIRA, NY DETROIT
Basic-Economy(E) 3:34pm 4:57pm
DELTA 2011 DETROIT INDIANAPOLIS,IN
Basic Economy(E) 5:30pm 6:44pm
*Flight 3704 Operated.by ENDEAVOR AIR DBA DELTA CONNECTION
*Flight 6216 Operated by GOJET AIRLINES DBA DELTA CONNECTION
*Flight 6253 Operated by GOJET AIRLINES DBA DELTA CONNECTION
AUTOMATIC CHECK-IN NOW AVAILABLE
We've added Automatic Check-In to the Fly Delta app to save you time and hassle.This means if
you're traveling in the United States,Puerto Rico or the U.S Virgin Islands,we'll automatically
check you in 24 hours prior to your scheduled departure.Just open the app and you'll be on your
way. Don't have the app?Click here to download. Learn more about automatic check-in.
RESTRICTED HAZARDOUS ITEMS
To ensure the safety of our customers and employees,Delta will no longer accept smart bags
starting January 15,2018.Smart bags with non-removable lithium-ion batteries will not.be
permitted as carry-on or checked baggage on any Delta mainline or Delta Connection flight. For
1
more information,please visit our News Hub.
Hoverboards or any lithium battery powered self-balancingpersonal transportation devices are
also not permitted as both carry-on and checked baggage.
Spare batteries for other devices,fuel cells,and e-cigarettes are permitted in carry-on baggage
only.If.your carry-on bag contains these items and is gate checked,they must be removed and
carried.in the cabin. Further information and specific guidelines regarding restricted items can be
found here.
Passenger Info
NAME FLIGHT SEAT
KEITH FREER DELTA 3704 Select Seat
DELTA 6216 Select Seat
DELTA 6253 Select Seat
DELTA 2011 Select Seat
Visit delta.com or use the Fly Delta app to view, select or change your seat.
If you-purchased a Delta Comfort+TM seat or a Trip Extra, please visit My Trips to access a receipt
of your purchase.
Flight Receipt
Ticket#: 0062311659239
Place of Issue: Delta.com
Ticket Issue Date: 303AN18
Ticket Expiration Date: 30JAN19
METHOD OF PAYMENT
VI************6579 $376.00 USD
CHARGES
Air Transportation Charges
Base Fare $306.98 USD
Taxes,Fees and Charges
United States-September 11th Security Fee(Passenger $11.20 USD
Civil Aviation Security Service Fee).(AY)
United States-Transportation Tax(US) $23.02 USD
United States- Passenger Facility Charge(XF) $18.00 USD-
United States-Flight Segment Tax(ZP) $16.80 USD
TICKET AMOUNT $376.00 USD
NONREF/NOCHGS/NOPRE RSVDSEAT
2
Review your itinerary
hetwire
Everything is set for your car rental in
Horseheads
Your Hotwire confirmation number'-is 4782822364 s
Pickup i Drop off - -
I
May 3, 2018 May 6,2018
11:30AM 1:30PM I
National National
i Elmira/Corning, ELM s Elmira/Corning, ELM
276 Sing Sing Rd Ste 10 276 Sing Sing Rd Ste 10
Horseheads, NY Horseheads, NY
I
1-800-468-3334 Map 1-800-468-3334 Map
I Y I
{ Hours of operation: I Hours of operation:
Thu 07:00 AM - 10:30 PM Sun 09:00 AM - 10:30 PM i
I Ij
National accepts credit card deposits. Debit/check card deposits are accepted with proof of a round-trip travel
ticket.
Your reserved car »
1 Standard Features
Volkswagen Jetta or Automatic Transmission, Power Steering,Air !
�. . similar Conditioning,Air Bags,Anti-Lock Brakes,
AM/FM Stereo
� 5 UM 0 2 i
I
I {
Get your detailed itinerary online and make changes anytime.
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Reservation details
National confirmation# 1164106872 Contact phone (317)460-5792
Driver name Keith Freer Contact email kfreer(aD-carmel.in.gov
Price summary (USD)
4 days x 38.04 152.18
Taxes and fees 53.98
Subtotal 196.16
Discount amount -10.00
Hotwire Total (USD) 196.16 (Charged to Visa ending in 6579 on Apr 29, 2018)
Payment summary
Customer name Keith Freer Payment method Visa ending in 6579
Phone number (317)460-5792 Transaction date Apr 29, 2018
Know before you go
Payment The agency requires a credit/debit card in the driver's name for deposit.
The amount varies and can't be used on your card until you return the car.
See important debit card info
Driver info Bring driver's licenses for each person who will be driving the car.
Drivers under the age of 25 may be required to pay an additional fee,
contact the rental agency for details. There may also be a fee for
additional drivers.
More info Print a copy of this email and bring it with you when you pick up your
rental. Supplier terms and conditions
Mileage Unlimited
Booking rules All Hotwire Hot Rate* bookings are final. No changes or refunds are
allowed.
Special requests For hours of operation, special requests such as GPS, child seats, racks,
and additional drivers, please call your car rental agency. An additional fee
may be required for special request items.
Prevent theft Remove valuables from the rental car and lock doors.
Insurance May not include mandatory insurance charges required for certain
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National 1-800-468-3334
U.S./Canada 1-800'-845-4026 (24/7, toll-free)
International 1-417-520-1680 (fees may apply)
Allianz Global Assistance 1-800-771-1281 (fees may apply)
FAQ Visit our help center
Itinerary# 4782822364
. . nimunmuuminimnnnuinuuiiunuuiiunuiuiiimi
RA#341163615 RES#1164106872
KEITH FREER ACCOUNT HOTWIRE OPAQUE EC#
ALEXANDRIA,IN 46001 _DAILY FT#
EXT REF#4782822364
RENTAL LOCATION RENTAL DATE RETURN LOCATION RETURN DATE
ELMIRA CORNING REG ARPT(844)8164388 03-MAY-2018 ELMIRA CORNING REG ARPT(844)8164388 06-MAY-2018
276 SING SING RD STE 10 RENTAL TIME 276 SING SING RD STE 10 RETURN TIME
HORSEHEADS,NY 14845-7901 11:47 AM HORSEHEADS,NY 14845-7901 01:30 PM
RATE RULES AND QUALIFICATIONS INITIAL X VEHICLE INFORMATION
HOTWIRE OPAQUE 4 DAY RESERVED STANDARD 2/4 DOOR AUTOMATIC A/C
Min.rental 74 hours DRIVEN Premium Special Auto A/C
Max.rental 98 hours CHARGED STANDARD 2/4 DOOR AUTOMATIC A/C
MAKE CHRYSLER
MODEL 300
COLOR WHITE
ODOMETER 14887
PLATE AD45445
REG AREA IL
VEHICLE# JH170941
BAY R1
-- - — ---- - STALL A10_
CHARGES UNIT PRICE/UNIT CURRENT CHARGE
• TIME&DISTANCE Rental INCLUDED
. EXTRA-TIME&DISTANCE Day INCLUDED
. EXTRA-TIME&DISTANCE Hour INCLUDED
. EXTRA-TIME&DISTANCE WEEK INCLUDED
• UNLIMITED MILES/KM-TIME&DISTANCE M/KM INCLUDED
• CONCESSION RECOVERY FEE 11.11 PCT @ 11.11% INCLUDED
CAR RENTAL SALES TAX 6 PCT @ 6.00% INCLUDED
SALES TAX 8.00% INCLUDED
RENTER'S RESPONSIBILITY
• EXTENSION-TIME&DISTANCE Day 67.47 X 0.00
' EXTENSION-TIME&DISTANCE Hour 33.74 X 0.00
. EXTENSION-TIME&DISTANCE WEEK 404.82 X 0.00
LDW Day 9.00 X 4 36.00
ROADSIDE PLUS Day 6.99 X 4 27.96
• REFUELING SERVICE CHARGE Gallon 4.29 X 0.00
• CONCESSION RECOVERY FEE 11.11 PCT @ 11.11% 7.11
CAR RENTAL SALES TAX 6 PCT @ 6.00% 2.10
SALES TAX 8.00% 2.81
ESTIMATED CHARGES 75.98 INITIAL X
(ALL CHARGES ARE ESTIMATE ONLY-SUBJECT TO CHANGE IF VEHICLE NOT
RETURNED TO THE LOCATION ON DATE AND TIME SPECIFIED,OR IF FUEL TANK IS
NOT FULL AT RETURN AND FUEL SERVICE OPTION WAS NOT PURCHASED).
PAYMENTS
_-EXTERNAL TOUR VOUCHER 4782822364/_4/SCA_R.
VISA 6579 Auth#
YOU ACCEPT OPTIONAL LDW AT$9.00 PER DAY AND HAVE READ THE PROVISIONS PERTAINING TO LDW CONTAINED WITHIN THIS
AGREEMENT,INCLUDING THE RENTAL AGREEMENT JACKET AND THE APPLICABLE BROCHURE.X
I ACCEPT NATIONAL'S OPTIONAL ROADSIDE SERVICE PLUS AT$6.99 PER DAY X
I DECLINE PERSONAL ACCIDENT INSURANCE(PAI).X
I DECLINE OPTIONAL THIRD PARTY BODILY INJURY AND PROPERTY DAMAGE INSURANCE(SLI).X
RA#341163615
PAGE 1OF2
:Z::�,:Naffbnal RA # 341163615 Bill Ref# 30033189815
Rental Location Renter Name KEITH FREER
ELMIRA CORNING REG ARPT 03-MAY-2018 11:47 AM 1413 N FAIRVIEW AVE
276 SING SING RD STE 10 ALEXANDRIA IN 46001
HORSEHEADS NY 14845-7 Phone (844)8164388
HOTWIRE OPAQUE DAILY
Contract IDi
Return Location
ELMIRA CORNING REG ARPT 06-MAY-2018 02:30 PM
I
Charges No Unit Price/Unit Amount
I
Vehicle # JH170941 DAMAGE WAIVER 4 Days 9.00 36.00
Model 300 RAP i 4 Days 6.99 27.96
Class Driven PXAR CONCESSION RECOVERY FEE 11.11 PCT 63.96 7.11
Class Charge SCAR CAR RENTAL SALES TAX 6 PCT 35.07 2.10
License# AD45445 SALES TAX @8.000 % 35.07 2.81
State/Province ILLINOIS
M/Kms Driven 110
M/Kms Out 14887
M/Kms In 14997
Rate Info
Messages
* Taxable Items
Subject to Audit
Total Charges USD 75.98
I
Payments
Visa 6579
RUTH: 04386D 03-MAY-2018 75.98 Payment -75.98
Customer Service Number 1-800-468-3334
Amount Due 1 USD 0.00
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CREDIT CARD (...6579)
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