188953 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 364564 Page 1 of 1
ONE CIVIC SQUARE RICHARD PIFER
0
CARMEL, INDIANA 46032 1466 N soo w CHECK AMOUNT: $1,030.36
GREE,NFIELD IN 46140 CHECK NUMBER: 188953
CHECK DATE: 8/18/2010
DE PARTME NT ACCO P O N UMBER INVOICE NU MBER AMO UNT DESCRIPTION
2201 4343002 1,030.36 EXTERNAL TRAINING TRA
y M FI
t
CITY OF CARMEL Expense Report (required for all travel expenses)
HDIANP�
EMPLOYEE NAME: _Parks Pifer DEPARTURE DATE: I TIME: L OCR AM M
DEPARTMENT: STREET RETURN DATE: 1 TIME: AM M
REASON FOR TRAVEL: _X DESTINATION CITY. Chicago, IL
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM _X_
Da Lodging Transportation Gas /Tolls/ Meals Misc. Total
a Par
-0 in Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
7/5/10 $5.10 $220.42 $65.00 $290.52
7126/10 $220.42;`(! $65.00 $285.42
7/27/10 $104.00 $220.42 V $65.00 $389.42
7/28110 $65.00 $65.00
$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
$0.00
0.00
Total $0.00 $0.00i $109.101 $661.261 $0.001 $0.09L $0.001 $0.00 $260.001 $0.00
DIRECTOR'S STATEM T: 1 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 8/10/2010 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.
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 docume expenditures) g d ducted from the first paycheck issued more than 30 days after the date of my return.
Employee Signature: Date: ID
City of Carmel Form ER06 Revision Date 8/10/2010 Page 2
Sbembon Chicago Hole) Towen
301 E North Water St
Chkoigo: IL 60611-4534 US V
1 312 464 1000
1 312 464 4140 Sheraton
row
RATE 2823
Mr Parks Pifer IPERS. 191.00
FOLK) 1
1466n 600w PAGE 3967272 EX -A
Greenfield, -IN 46140 AFF4vt 1
DEPART 25 18:3 8
PAYMEW 28- JUL -10 13:00
25- JUL -10 RT2823 Room Chrg Grp Association .191.00
25- JUL -10 RT2823 Occupancy /Tourism Tax 22.73
25- JUL -10 RT2823 Tax Other 6.69
25- JUL -10 DEPOSIT Deposit Applied 220.41-
26- JUL -10 RT2823 Room Chrg Grp Association 191.00
26- JUL -10 RT2823 Occupancy /Tourism Tax 22.73
26- JUL -10 RT2823 Tax Other 6.69
27- JUL -10 RT2823 Room Chrg Grp Association 191.00
27- JUL -10 RT2823 Occupancy /Tourism Tax 22.73
27- JUL -10 RT2823 Tax Other 6.69
28- JUL -10 440.85
Balance Due 0.00
For your convenience, we'have prepared this zero- balance folio indicating a
$0 balance due on your account. Please be advised that charges not reflected
on this folio will be'charged to the credit card on file with the hotel.
This charge may occur after your departure. You are.responsible to pay all
of your charges in full. If you provide us with an email address, we can
email you a final.copy of your charges. Please contact our guest services
team at ext. 80.
continued on the next page
S]QgATURE r apes a �en,eN ae lade tr r,e d ea aooad eq ao<peo6on «oases ei�o porq cam fib a am can d e+ese des gr�
Mr Parks Pifer ROOM DEPART AGENT_
FOLIO 3967272 25- JUL -10 2823
56eraton chioago Hatd Towen
301 E North Water St�
Chk ago. X 60611 -4534 US V
1 312 464 1000
1 312 464 4140
Sheniton
ROOM
BATE
rPER& 2823
Mr Parks Pifer FOW 191.00
FM;E 1
1466n 600w 3967272 EX -A
Greenfield, 46140 2
DEPART
PAYk*W 25- JUL -10 18:38
EXPENSE REPORT SUMMARY
Date Room &Tax Food &Bev Telephone Parking Other Total Payment
25- JUL -10 220.42 0.00 0.00 0.00. 0.00 220.42 -220.41
26- JUL -10 220.42 0..00 0.00 0.0e 0.00 220.42 0.00
27- JUL -10 220.42 0.00 0.00 0.00 0.00 220.42 0.00
Total 661.26 0.00 0.00 0.00 0.00 661.26 220.41
Thank you for choosing Starwood Hotels- Sheraton Chicago. We look forward to welcoming you
back soon!
Turn your stays into getaways. Starwood Preferred Guest members earn
Star for their stays that can be used to transform travel and
entertainment dreams into reality; from free nights and free flights without
blackout .dates to merchandise to Once -in -a- lifetime experiences. If you are
not already a member, join at. the front desk or at www.SPG.com
SIGNATURE I PWw a ianet� vdsoieh bde our ne pnrmerta ws �000u r ns mpowbm v atler eind pa�q eeea kb �o Pq patron r d 4ese ahrgei
As a Starwood preferred Guest you have earned at least 1146
Starpoints for this visit A42305613538
Mr Parks Pifer ROOM DEPART AGENT
FOLIO 3967272 25- JUL -10 2823
VOUCHER NO. WARRANT NO.
ALLOWED 20
Parks Pifer
IN SUM OF
c/o Carmel Street Department
$1,030.36
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO #1 Dept. INVOICE NO- ACCT #(TITLE AMOUNT Board MemberE
2201 43- 430.02 $1,030.36 1 hereby certify that the attached invoice(s), or
bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursd o �August 12, 2010
Street Commissioner
st
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 dumber (or note attached invoice(s) or bill(s))
08/10/10 $1,030.36
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