183453 03/16/2010 "y CITY OF CARMEL, INDIANA VENDOR: 362627 Page 1 of 1
ONE CIVIC SQUARE KURT SHANAYDA CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 3391 S BELL CREEK RD
YORKTOWN IN 47396 CHECK NUMBER: 183453
CHECK DATE: 3/16/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 022410 150.00 EXTERNAL TRAINING TRA
6F Qj4
CITY OF CARMEL Expense Report (required for all travel expenses)
/NDIAN P
EMPLOYEE NAME: Kurt Shanayda DEPARTURE DATE: 2/22/2010 TIME: 12:00 PM
DEPARTMENT: IS RETURN DATE: 2/24/2010 TIME: 4:30 PM
REASON FOR TRAVEL: Indiana GIS Conference DESTINATION CITY: Bloomington, IN
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT x PER DIEM x
Transportation Gas /Tolls/ Meals
Date Lodging Misc. Total
Parkin
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
2/22/10 $50.00 $50.00
2123110 $50.00 $50.00
2124/10 $50.00 $50
$0:00
$000
$0.00
.:::10.00
::$0.00.
$0:00
$0.00
$0:00
00
I $0:00
$0:00
$0.00
$0:00
$0:00
$0:00
0',00
Total $0.00 $000..0 $0.00' $o'.00 $.0.00' $0.00 $0::00 $0.0..0 $150.x0, $0:00 A $,1'S0 -0;0
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: r Date: 432e
v
City of Carmel For R06 Revision Date 3/1/2010 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 $60 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 $60 for out -of -state travel
EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES:
I hereby acknowledge receipt of 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 expenditur eing deducted from the first paycheck issued more than 30 days aft/th date of my return.
Employee Signature: Date:
1
City of Carmel Form ERO6 Revision Date 3/1/2010 Page 2
eFo110 Page 1 of 2
Shanayda, Kurt A
From: Krueskamp, Theresa A
Sent: Monday, March 01, 2010 1:44 PM
To: Shanayda, Kurt A
Subject: FW: Your Feb 22, 2010 Feb 24, 2010 stay at the Courtyard Bloomington
Terry Krueskamp
GIS Coordinator, City of Carmel
3 Civic Square
Carmel, Indiana 46032
(317) 571 -2565
tkrueskamp @carmel.in.gov
From: Thanks for staying! [mailto:efolio @courtyard.com]
Sent: Friday, February 26, 2010 4:51 AM
To: Krueskamp, Theresa A
Subject: Your Feb 22, 2010 Feb 24, 2010 stay at the Courtyard Bloomington
Thank you for choosing the Courtyard Bloomington for your
recent stay.
As requested, below is a billing summary or adjustment for l
your stay. If you have questions about your bill, please
contact the hotel directly at (812) 335 -8000.
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Make another reservation on Marriott.com may receive this email
automatically after every stay.
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Summary of Your Stay
Hotel: Courtyard Bloomington Guest: THERESA /MRS KRUESKAMP
310 S. College Avenue CITY OF CARMEL
Bloomington, Indiana 47403 3 CIVIC SQUARE
USA CARMEL, IN 46032
(812) 335 -8000 USA
Dates of stay: Feb 22, 2010 Feb 24, 2010 Room number: 211
Guest number: 63268 Group number:
Marriott Rewards number: XXXXX4090
t�
Date Description Reference Charges Credits
02/22/10 Transfer TF63267 99.68
02/22/10 ROOM CHARGE RB211 89.00
02/22/10 Room Tax RT211 6.23
02/22/10 City Tax CT211 4.45
02/23/10 Transfer TF63267 99.68
3/1/2010
eFolio Page 2 of 2
02/23/10 ROOM CHARGE RB211 89.00
02/23/10 Room Tax RT211 6.23
02/23/10 City Tax CT211 4.45
Total balance 0.00 USD
Was that the best night's sleep you've ever had? How about a repeat performance at your place!
w ��.�,w
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3/1/2010
VOUCHER NO. VIVARRAgT NO,
ALLOWED 20
Shanayda, Kurt
IN SUM OF
$150.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel IS Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
1202 I 022410 I 43- 430.02 I $150.00 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
A/ Friday, March 12, 2010
Direct I.
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/24/10 022410 $150.00
1 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
Clerk Treasurer