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Home My WebLink About329961 09/13/18 i u�.CAA1! \� CITY OF CARMEL, INDIANA VENDOR: 364386 d z;• ONE CIVIC SQUARE KURT ANDERSON CHECK AMOUNT: $*******456.27* ;� ;?� CARMEL, INDIANA 46032 C/O ENGINEERING CHECK NUMBER: 329961 �.�TON� CHECK DATE: 09/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4343002 REIMB 456.27 EXTERNAL TRAINING TRA VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 364386 KURT ANDERSON IN SUM OF$ CITY OF CARMEL C/O ENGINEERING 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 $456.27 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Engineering 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 9043979 43-430.02 $42.32 1 hereby certify that the attached invoice(s),or 9/5/18 9043979 Gasoline $42.32 2200 2200 2200 2200 52660609 43-430.02 $104.65 bill(s)is(are)true and correct and that the 9/6/18 52660609 Lodging-Thomas $104.65 2200 2200 materials or services itemized thereon for 2200 2200 52660609 43-430.02 $104.65 9/6/18 52660609 Lodging-Anderson $104.65 2200 2200 which charge is made were ordered and 2200 2200 52660609 43-430.02 $104.65 received except 9/6/19 52660609 Lodging-Jordan $104.65 2200 2200 Prior Year 2200 2200 0 43-430.02 $100.00 9/12/19 0 Per Diem $100.00 2200 2200 Prior Year 2200 2200 - Wednesday, September 12,2018 Jeremy Kashman Director 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 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer OF CA W.", CITY OF CARMEL Expense Report (required for all travel expenses) � .", EXHIBIT A EMPLOYEE NAME: er o DEPARTURE DATE: 9-`S--/� TIME: T-10 /PM DEPARTMENT:�i��ir�eei��--� RETURN DATE: 7-Gl� TIME: 7. 0 AM/a REASON FOR TRAVEL:.1n-,zTrj DESTINATION CITY: Z7 Van, EXPENSES ARE FOR (check all that apply):TRAVEL ADVANCE TRAVEL REIMBURSEMENT ✓ TRAVEL PER DIEM ✓ Transportation Meals Date Gas/Tolls/ Lodging Misc. Tota1. Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 9/5/18 $42.32 $42.32 9/5/18 $104.65 $104:65 9/5/18 $104.65 $104;65 9/5/18 $104.65 :$104:05 9/5/18 $50.00 '$50:00 9/6/18 $50.00 $50:00 $0.00 $0:00 $0:00 $O 90 $0:00 $0:00 $0:(00 .$0:00 $0 00 w$0`00 t 0.00 Total $0.00 $0:00 $0,.00', $42.32 $313,95 $0,0.0 .$0.00 MOI $0:00 '$100.001 $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 9/10/2018 Page 1 DOUBLETREE BY HILTON EVANSVILLE 601 WALNUT STREET IV EVANSVILLE,IN 47708 DOUBUTREE United States of America nr ua4rav• TELEPHONE 812-423-5002 •FAX 812-423-5004 Reservations www.hilton.com or 1 800 HILTONS ANDERSON,KURT Room No: 422/NKR Arrival Date: 9/5/2018 2:49:00 PM 11245 HEARTHSTONE DR Departure Date: 9/6/2018 10:06:00 AM Adult/Child: 1/0 FISHERS IN 46037 Cashier ID: ACAMPBELL34 UNITED STATES OF AMERICA Room Rate: 91.00 AL: HH# 212778923 BLUE VAT# Folio No/Che 101187 A Confirmation Number:52660609 DOUBLETREE BY HILTON EVANSVILLE 9/6/2018 10:05:00 AM DATE I REF NO IDESCRIPTION I CHARGES 9/5/2018 411251 GUEST ROOM $91.00 9/5/2018 411251 ROOM STATE TAX-7.00% $6.37 9/5/2018 411251 ROOM OCCUPANCY TAX-8% $7.28 9/6/2018 411573 VS*4026 ($104.65) —BALANCE— $0.00 EXPENSE REPORT SUMMARY 9/5/2018 STAY TOTAL ROOM AND TAX $104.65 $104.65 DAILY TOTAL $104.65 $104.65 Hilton Honors(R)stays are posted within 72 hours of checkout.To check your earnings or book your next stay at more than 4,000 hotels and resorts in 100 countries,please visit Honors.com Thank you for choosing Doubletree!Come back soon to enjoy our warm chocolate chip cookies and relaxed hospitality.For your next trip visit us at doubletree.com for our best available rates! CREDIT CARD DETAIL APPR CODE 05510B MERCHANT ID 8030879376 CARD NUMBER VS*4026 EXP DATE 02/22 TRANSACTION ID 411573 TRANS TYPE Sale Page:1 DOUBLETREE BY HILTON EVANSVILLE 601 WALNUT STREET Sri EVANSVILLE,IN 47708 DOUBLETREE United States of America nr wi4row TELEPHONE 812-423-5002 •FAX 812-423-5004 Reservations www.hilton.com or 1 800 HILTONS THOMAS,JOHN Room No: 405/NKR Arrival Date: 9/5/2018 2:52:00 PM 11245 HEARTHSTONE DR Departure Date: 9/6/2018 11:50:00 AM Adult/Child: 1/0 FISHERS IN 46037 Cashier ID: ACAMPBELL34 UNITED STATES OF AMERICA Room Rate: 91.00 AL: HH# 212778923 BLUE VAT# Folio No/Che 101188 A Confirmation Number:52660609 DOUBLETREE BY HILTON EVANSVILLE 9/6/2018 11:49:00 AM DATE I REF NO IDESCRIPTION CHARGES 9/5/2018 411237 GUEST ROOM $91.00 9/5/2018 411237 ROOM STATE TAX-7.00% $6.37 9/5/2018 411237 ROOM OCCUPANCY TAX-8% $7.28 9/6/2018 411634 VS*4026 ($104.65) `*BALANCE— $0.00 EXPENSE REPORT SUMMARY 9/5/2018 STAY TOTAL ROOM AND TAX $104.65 $104.65 DAILY TOTAL $104.65 $104.65 CREDIT CARD DETAIL APPR CODE 06752B MERCHANT ID 8030879376 CARD NUMBER VS*4026 EXP DATE 02/22 TRANSACTION ID 411634 TRANS TYPE Sale Page:1 DOUBLETREE BY HILTON EVANSVILLE 601 WALNUT STREET EVANSVILLE,IN 47708 DOUBLETREE United States of America n. H4ro� TELEPHONE 812-423-5002 •FAX 812-423-5004 Reservations www.hilton.com or 1 800 HILTONS ANDERSON,KURT k00171 ' Room No: 413/NKR Arrival Date: 9/5/2018 2:51:00 PM 11245 HEARTHSTONE DR Departure Date: 9/6/2018 10:06:00 AM Adult/Child: 1/0 FISHERS IN 46037 Cashier ID: ACAMPBELL34 UNITED STATES OF AMERICA Room Rate: 91.00 AL: HH# 212778923 BLUE VAT# Folio No/Che 101186 A Confirmation Number:52660609 DOUBLETREE BY HILTON EVANSVILLE 9/6/2018 10:05:00 AM DATE I REF NO IDESCRIPTION CHARGES 9/5/2018 411245 GUEST ROOM $91.00 9/5/2018 411245 ROOM STATE TAX-7.00% $6.37 9/5/2018 411245 ROOM OCCUPANCY TAX-8% $7.28 9/6/2018 411576 VS*4026 ($104.65) —BALANCE" $0.00 EXPENSE REPORT SUMMARY 9/5/2018 STAY TOTAL ROOM AND TAX $104.65 $104.65 DAILY TOTAL $104.65 $104.65 Hilton Honors(R)stays are posted within 72 hours of checkout.To check your earnings or book your next stay at more than 4,000 hotels and resorts in 100 countries,please visit Honors.com Thank you for choosing Doubletree!Come back soon to enjoy our warm chocolate chip cookies and relaxed hospitality.For your next trip visit us at doubletree.com for our best available rates! CREDIT CARD DETAIL APPR CODE 03227B MERCHANT ID 8030879376 CARD NUMBER VS*4026 EXP DATE 02/22 TRANSACTION ID 411576 TRANS TYPE Sale Page:1 Welcome to Shell CROSS POINTE SHELL 101 CROSSPOINT BLVD EVANSVILLE, IN 574459. 96804 SHELL 101 CROSS POINTE BLVD EVANSVILLE IN PRINT TABLE OA DATE 09/05/12 11 :43 TRAN# 9043979 PUMP# 04 SERVICE LEVEL: SELF PRODUCT: UNLD GALLONS: 13.229 PRICE/G: $ 3.199 FUEL SALE $ 42.32 CREDIT $42.32 XXXX XXXX XXXX 4026 VISA Swiped APPROVED AUTH # 60480B INV # 001917 --- ---------------- Please come again THANK YOU COME BACK SOON