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183913 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 359024 Page 1 of 1 s ONE CIVIC SQUARE TARA POLOVICK CHECK AMOUNT: $24.50 CARMEL, INDIANA 46032 P O BOX 1795 CARMEL IN 46082 -1795 CHECK NUMBER: 183913 CHECK DATE: 3/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4343002 24.50 EXTERNAL TRAINING TRA AYn Q, f CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: 1�O��V 1 DEPARTURE DATE: 3� 1Q C) TIME: (_O l 6g PM DEPARTMENT: (OOnrn kn� �C�h S RETURN DATE: 1 ©1. TIME: AM /(1 REASON FOR TRAVEL: 02A)�e_ 5a[X, �-SS DESTINATION CITY: A N EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas /Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem 3/10/09 $12.00 $12.50 $24.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.03 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.06 Totall $0.00 $0.00 $0.0 $0.001 $0.00 $12.001 $12.501 $0.001 $0.00 $0.00 $0.00 1 DIRECTOR'S STATEMENT: I In m that all ewense&onforrn to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: City of Carmel Form ER06 Revision Date 3/20/2010 Page 1 f 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 expenditures) bdeducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: VI IULf VY I City of Carmel Form ERO6 Revision Date 3/20/2010 Page 2 Expense Affidavit for Tara Polovick 3/10/2009 Breakfast $12.00 cash (including tips) Lunch $12.50 cash (including tip) Total $24.50 The expenses were paid by cash and no receipts are available. I certify that the amounts listed above are accurate. Signed A Date M ►,-�6) t7 Course Type: Active Shooting Response Course Date: Mar 10, 2010 Course Hours: 08:30 AM 04:30 PM Course Location: West Lafayette Police Department 711 West Navajo Drive West Lafayette, IN 47906 Host Aaencv and Contact: Host Agency: West Lafayette Police Department Contact: Sgt. John Watson Phone: (765) 775 -5260 E -mail Address: jdwatson@westlafayettepd.us For additional information regarding course location or local directions, please call the host agency's contact person at the above number. With any other questions, or to make additional registrations, please contact PowerPhone at 1 --800- 537 -6937 (outside the U.S., please call +1 203 245 8911). STUDENTS REGISTERED Total Students Registered: 6 Callahan, Nicholas P. Case, Darcy Jokantas, John M. Polonik, Tara Reed, Michele Southerland, Nicholas PAYMENT TERMS Payment in full is due upon receipt of order_ All course registrations must be paid in full prior to the start of class for students to attend. CANCELLATION POLICY FOR COURSE REGISTRATIONS If you cancel up to 30 days before the start of a program, there is no penalty. For any cancellation, you must call PowerPhone at 1 -800 -537 -6937 and obtain a cancellation number. Outside the U.S., please call +1 203 -245 -8911. The agency or individual is responsible for full payment to PowerPhone for any registration cancelled less than 30 days before a program, or for any student who is registered but does not attend. Student substitutions may be made at any time. PowerPhone, Inc. 9 -1 -1 Calls Us(TM) 2 Arnone, Janet R From: Heinzman, Mike D Sent: Monday, March 08, 2010 7:54 PM To: Thalia Savakis Cc: Polovick, Tara L; Callahan, Nicholas P; Case, Darcy L; Southerland, Nicholas R; Jokantas, John M; Reed, Michele R; Akers, William P; Arnone, Janet R Subject: RE: PowerPhone Registration Confirmation Actuallv one of the attendee's names is misspelled, below... "Tara Polovick" Thank you! "REMINDER TO ALL ABOVE" Enjoy your class! Original Message---- From: Thalia Savakis [mailto:thalia @powerphone.com] Sent: Monday, March 08, 2010 10:33 AM To: Heinzman, Mike D Subject: PowerPhone Registration Confirmation This confirms your PowerPhone Course Registration Thank you for choosing PowerPhone! Below is your confirmation for the PowerPhone course listed below. Please review this information carefully, including all student names. If any information needs to be changed, please reply to this e -mail as soon as possible and let us know what needs to be changed. Billing Information You will receive a separate invoice or receipt for your order from PowerPhone's accounting department. Date: 3/8/2010 YOUR INFORMATION Carmel Clay Communications Contact: Mike Heinzman 31 First Ave Nw Carmel, IN 46032 Phone: (317) 571 -2586 Fax: (317) 571 -2585 E -mail: mheinzman @carmel.in.gov COURSE INFORMATION Course 09 -1174 1 V NO., WARRA NO. ALLOWED 20 Tara Polovick IN SUM OF 13154 Dunwoody Lane Carmel, In 46033 $24.50 r ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1115 43- 430.02 $24.50 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 Wednesday, March 24, 2010 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by Stale 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)) 03/22110 I I I $24.50 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