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332964 12/06/18
CITY OF CARMEL, INDIANA VENDOR: 356653 ® ONE CIVIC SQUARE ALEXIA LOPEZ CHECK AMOUNT: $*"""*1,070.94' CARMEL, INDIANA 46032 1265 E 106TH STREET CHECK NUMBER: 332964 INDIANAPOLIS IN 46280 CHECK DATE: 12/06/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343001 . 203.58 TRAVEL FEES & EXPENSE 1192 4343002 867.36 EXTERNAL TRAINING TRA VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) Vendor# 356653 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ALEXIA LOPEZ IN SUM OF$ CITY OF CARMEL 1265 E 106TH 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. INDIANAPOLIS, IN 46280 Payee $1,070.94 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 Lopez 43-430.02 $195.00 1 hereby certify that the attached invoice(s),or 12/3/18 Lopez Per diem for Greenbuild Conf in Chicago- $195.00 1192 101 1192 101 Lopez Lopez 43-430.02 $672.36 bill(s)is(are)true and correct and that the 12/3/18 Lopez Hotel for Greenbuild Conf in Chicago-Lopez $672.36 1192 101 materials or services itemized thereon for 1192 101 Lopez I 43-430.01 I $203.58 12/3/18 I Lopez which charge is made were ordered and I Parking,gas,tolls,public transit for Greenbuild I $203.58 1192 101 1192 101 Conf in Chicago-Lopez received except Monday, December 03,2018 Mike Hollibaugh 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 , 20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: Alexia Lopez DEPARTURE DATE: 11/13/2018 TIME: 8:30 PM DEPARTMENT: DOCS RETURN DATE: 11/16/2018 TIME: 6:30 PM REASON FOR TRAVEL:_USGBC Greenbuild Conference DESTINATION CITY: _Chicago, IL EXPENSES ARE FOR(check all that apply): TRAVEL REIMBURSEMENT X_ TRAVEL PER DIEM X_ Transportation Gas/Tolls/ Date Parking/Mileage. Hotel Misc. Total `y Air-fare Car Rental Parking545 Per Diem 11/13/18 Gas $25.38 $224.12 a' 124%'50 11/13/18 Toll 5.2 ~$5:2'0 11/13/18 Toll 2.4 r ' 11/14/18 Public Transit $3.00 $224.12 $65.00 �_ �,$29212 11/15/18 Public Transit $9.00 $224.12 $65.00 $298:12 11/16/18 $147.00 $65.00 $212.00 11/16/18 Public Transit $3.00 11/16/18 Toll $5.20 $5:20, 11/16/18 Toll $2.40 $2.40 11 11/16/18 Toll $1.00 $0:00 $0'°:00 0:0t) Total $0.00 $,0:00 '' $147.00 ''~ . $56:58 ' $672 36 $0:00 „ $0:00 $0:00` $0,:00 $1,95.00 $0:00 �, , a .. DIRECTOR'S STATEMENT: r,by aff th all x uses ' ted conform to the City's travel policy and are within_my department's appropriated budget. Director Signature: Date: I� y City of Carmel Form#ER06 Revision Date 12/3/2018 Page 1 Name and Address Hilton Hotel Address LOPEZ,ALEXIA 17 EAST MONROE STREET 1265 E 106TH ST HOTELS&RESORTS CHICAGO,IL 60603 INDIANAPOLIS,IN 46280 THE PALMER HOUSE HILTON Room 17135//D2RRX Reservations Arrival Date 11/13/18 www.hilton.com or Departure Date 11/16/18 1-800-HILTONS Adult/Child 1/0 Confirmation# 3494701291 Room Rate $190.90 Rate Plan L-H7F 11/16/18 PAGE 1. Honors# 174942888 Airline: DATE REFERENCE DESCRIPTION AMOUNT 11/13/18 21948654 GUEST ROOM $190.90 11/13/18 21948654 STATE OCCUPANCY TAX $22.72 11/13/18 21948654 CITY OCCUPANCY TAX $8.59 11/13/18 21948654 COUNTY OCCUPANCY TAX $1.91 11/14/18 21952501 GUEST ROOM $196.90 11/14/18 21952501 STATE OCCUPANCY TAX $22.72 11/14/18 21952501 CITY OCCUPANCY TAX $8.59 11/14/18 21952501 COUNTY OCCUPANCY TAX $1.91 11/15/18 21956407 GUEST ROOM $190.90 11/15/18 21956407 STATE OCCUPANCY TAX $22.72 11/15/18 21956407 CITY OCCUPANCY TAX $8.59 11/15/18 21956407 COUNTY OCCUPANCY TAX 11/16/18 21957675 '*****'**'**7873 ($672.36) •'BALANCE•' $0.00. The on-line el'olio is a courtesy Informational service,subject to Privacy Policy and Site Usage;actual folio kept in hotel records. Hilton WpIAORF CONRAD COr1O TAPESTRY Gnrdc Hilt.. Cllil() `� ® Hone HOME Hilton ._-.w. mounlslnee eMwa E. ©inrt ..&R.... crand%totlws Hilton HONORS 12/3/2018 Alexia Lopez-chase.com CHASE !i Printed from Chase Personal Online Alexia Lopez (...7873) Current balance Available credit Ultimate Rewards 5%cash back Activated (Oct-Dec) Next payment due Minimum payment due Remaining statement balance Automatic payment ism. SHOWING Search Filtered by: Nov 13, 2018 to Nov 16, 2018 Date Description Type Amount Nov 16, 2018 _ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- SEP, SKYWAY CONCESSION CO Sale -� i $5.20 https://secure0l a.chase.com/web/auth/dashboard#/dashboard/accounts/summary/creditCard;params=card,437028393 1/3 12/3/2018 Alexia Lopez-chase.com Nov 13, 2018 _ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ND `+�� SKYWAY CONCESSION CO Sale l $5.20 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- �Q 4��01 PILOT-00034 Sale ��� $25.38 JPMorgan Chase Bank,N.A.Member FDIC ©2018 JPMorgan Chase&Co. Equal Opportunity Lender 0 https://secure0l a.chase.com/web/auth/dashboard#/dashboard/accounts/summary/creditCard;params=card,437028393 3/3