184834 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 357005 Page 1 of 1
ONE CIVIC SQUARE DAVID LITTLEJOHN CHECK AMOUNT: $396.00
CARMEL, INDIANA 46032 4840 N. GUILFORD AVENUE
INDIANAPOLIS IN 46205 CHECK NUMBER: 184834
CHECK DATE: 4/2712010
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343002 REIMB 136.00 EXTERNAL TRAINING TRA
1192 4343004 REIMB 260.00 TRAVEL PER DIEMS
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CITY OF CARMEL Expense Report (required for all travel expenses)
/NOW"
EMPLOYEE NAME: David Littlejohn DEPARTURE DATE: 419/2009 TIME: 8:15 AM
DEPARTMENT: Community Services RETURN DATE: 4/13/2009 TIME: 7:10 PM
REASON FOR TRAVEL: APA Conference DESTINATION CITY: New Orleans, LA
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM X
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
419/10 $33.00 $9.00 $65.00 $107.00
4/10/10 $9.00 $9.00
4/11/10 1 $9.00 1 $65.00 $74.00
4112110 $9.00 $65.00 $74.00
4/13110 $58.00 $9.00 $65.00 $132.00
$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
$0.00
a.00
Total $OAO $0.00 $91.00 $45.00 $0.00 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00 I I
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 4/22/2010 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 alf 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) being deducted from the first paycheck issued more than 30 days after the date of my return.
Employee Signature: tax Date: i
City of Carmel Form ER06 Revision Date 4/22/2010 Page 2
Page 1 of 2
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Davie; Littlejohn
IN SUM OF
c/o One Civic Square
Carmel, IN 46032
$396.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1192 43- 430.02 $45.00 1 hereby certify that the attached invoice(s), or
1192 43- 430.02 $91.00 bill(s) is (are) true and correct and that the
1192 43- 430.04 $260.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, April 23, 2010
DitVtor,
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))
04/22/10 Parking Indy Airport David New Orleans $45.00
04/22/10 Luggage and cab fares David New Orleans $91.00
04123/10 Travel Per Diems David Littlejohn New Orleans $260.00
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
Clerk- Treasurer