HomeMy WebLinkAbout190682 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 028500 Page 1 of 1
ONE CIVIC SQUARE GARY BRANDT CHECK AMOUNT: $444.40
CARMEL, INDIANA 46032 212 WALTER STREET
ory o•: CARMEL IN 46032 CHECK NUMBER: 190682
CHECK DATE: 1 011 3/201 0
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 9.00 GASOLINE
1120 4343002 435.40 EXTERNAL TRAINING TRA
CITY OF CARMEL Expense Report (required for all travel expenses)
��'DIAN ai
EMPLOYEE NAME: ��t_.�. �--o DEPARTURE DATE: TIME: (A_M PM
DEPARTMENT: RETURN DATE: TIME: AM/ PM
REASON FOR TRAVEL: DESTINATION CITY: Q.
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$0.00
9126/10 $20.00 $65.00 $85.00
9/27/10 1 $65.00 $65.00
9/28/10 $65.00 $65.00
9/29/10 $9.00 $65.00 $74.00
10/1/10 $20.00 $70.40 $65.00 $155.40
$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
k7 f o tal $0.00 _$0.00 $40.00 $79.401 $0.001 $0.00 $0.00 $0.001 $0.001 $325.001 $0.00
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.
t
Director Signature: r Date:
TJ
City of Carmel Form ER06 Revision Date 1017!2010 Page 1
Page No.
RC�S�N 9700 International Drive
Orlando, FL 328.19
Tel: (407) 996 -9700
E L- Fax: (407) 996 -9111 RoSI- -lv Ho sL RF--,oRTs
Guest. Name: Gary Brandt Room 838
Carmel, IN 46032 USA Folio RR5C184A
Group 21188
Guests: 2
Clerk:
CL
Arrive: 09/26/10 Time: 02:55 PM De part: 10/01/10 Time: 07:39 :07 Status: FOL
Date Description Reference Comment Charges Credi
09/26/2010 PAY CHECK chk #189496 ap03275 08/31/2010 ($766.97)
09/26/2010 ROOM CHARGE 838 $135.00
09/26/2010 ROOM TAX 838t ROOM TAX $17.05
09/26%2010 OCCCD SURCHARGE 838t OCCCD SURCHARGE $1.35
09/27/2010 ROOM CHARGE 838 $135.00
09/27/2010 ROOM TAX 838t ROOM TAX $17.05
09127/2010 OCCCD SURCHARGE 838t OCCCD SURCHARGE $1.35
09/28/2010 ROOM CHARGE 838 $135.00
09/28/2010 ROOM TAX 838t ROOM TAX $17.05
09/28/2010 OCCCD SURCHARGE 838t OCCCD SURCHARGE $1..35__
09/29/2010 ROOM CHARGE 838 $135.00
09/29/2010 ROOM TAX 838t ROOM TAX $17.05
09/29/2010 OCCCD SURCHARGE 838t OCCCD SURCHARGE $1.35
09/30/2010 ROOM CHARGE 838 $135.00
09/30/2010 ROOM TAX 838t ROOM TAX $17.05
09/30/2010 OCCCD SURCHARGE 838t OCCCD SURCHARGE $1.35
1010112010 PAY CASH 100195035031 ($0.03)
Folio Balance: $0.00
The Hotel has an agreement with the Orange County Convention Center (OCCC) and other properties in the Orange County Convention Center District OCCCD) to pay one
percent of the room rate as a surcharge (not subject to tax exemption). The OCCCD 1% surcharge shall be used to promote the Orange County Convention Center and tourist
services in the vicinity of the Orange County Convention Center District.
If I elect to pay by credit card, I understand that: acceptance is subject to approval by the issuing organization; information necessary to charge my credit card account will
appear on my itmized hotel folio (s) and be transmitted electronically in lieu of a sales draft; my liability for this bill is not waived and agree that in the.event the indicated
person, company, or association,fails to pay; l will be held responsible.
LUIk ycw Arc Rw7sing ti) my at the HiMI. OUr rcgistration r cor�I itidik1.atc
11 you will be departing May. As a rerTillider, wir checkwa tine is 1 1:00A.NI.
fora (titer check cw. please ttyn as the Desk at exr. 1577, asI�itc
�_l1<1rr�c nuly akpply.
If �1 credit card was presented at check -in or it b (ir Pc, ount k paiid in full, %v,': ,lrc
ploased to (liter m)J recotnmcnd .1 c{cuc mid n1c°th'id A :1 cc ou1. T hJ'5 wiil
chmitZ,lte y na need to qup by the I~r+mu I_Wk.
ShnpV dhd ext. 1700 fn"n yOctr morn [►fume V (1(ir Express (.1 ck -Out N�Ia NNix-
Leave Vow Marne, nxAn lannher And tine of oleparttire wlic:11 protnptcd icy th, ton
We will (_ki the re st. I'lease retain this pilling <is y(iur lin,al rcceipt. Ally ch.lr,s
WCUrcd after the printing of this hdhn mill be to yr()ur credit- card.
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Page I of 2
Snyder, Denise W
From: Debbie Tunstill Debbie. Tunstill @thetravelagentinc.com]
Sent: Thursday, September 02, 2010 1:28 AM
To: Snyder, Denise W
Subject: Confirmed Flight for Brandt
SALES PERSON: DT2 ITINERARY /INVOICE NO. ITIN DATE: SEP 02 2010
ACCOUNT NRTXIE PAGE: 01
FOR:
BRANDT /GARY D
TO: CITY OF CARMEL CITY OF CARMEL -FIRE DEPT
ONE CIVIC SQUARE 3RD FLOOR ATTN: DENISE SNYDER
CARMEL IN 46032 TWO CIVIC SQUARE
CARMEL IN 46032
26 SEP 10 SUNDAY MILES- 828 ELAPSED TIME- 2:11
AIR LV INDIANAPOLIS 1126A AIRTRAN AIR FLT: 399 COACH CLASS CONFIRMED
AR ORLANDO /INTL 137P NONSTOP
AIRTRAN CONF MFLIQH
SEAT 18C
01 OCT 10 FRIDAY MILES- 828 ELAPSED TIME- 2:16
AIR LV ORLANDO /INTL 354P AIRTRAN AIR FLT: 394 COACH CLASS CONFIRMED
AR INDIANAPOLIS 610P NONSTOP
AIRTRAN CONF MFLIQH
SEAT 25C
*YOU MUST VERIFY ALL INFORMATION IS CORRECT. ONCE ISSUED
FEES AND PENALTIES EXIST FOR REISSUES- REFUNDS CHANGES. FOR
AFTER HOURS EMERGENCIES ON EXISTING RESERVATIONS CALL
877 6456373 CODE A09. $15.00 PER CALL FEE WILL BE CHARGED
A CANCELLATION FEE OF 15PCT ON TTL COST OF BOOKED TOURS- CRUISES
LAND HOTEL PKGS. WILL APPLY. AIRLINE CHECKED BAGGAGE NOTICE
FOR DOMESTIC AND INTERNATIONAL TRAVEL AIRLINES MAY CHARGE
THE TRAVEL AGENT THANKS YOU -317 846 9619..DEBBIE WWW.TTA.TRAVEL
AIR TRANSPORTATION 173.95 TAX 34.45 TTL 208.40
PROCESSING FEE 35.00
SUB TOTAL 243.40
CREDIT CARD PAYMENT 243.40
TOTAL AMOUNT 0.00
10/7/2010
Registration F®rM (Register online at www.fdsoa.org)
FDSOA Annual Safety Forum Pre-Registration Required
NOTE: Use one registration form per person photocopies accepted. Please return completed
form, with payment in U.S. funds, to FDSOA, P.O. Box 149, Ashland, MA 017210149. Make
checks payable to FDSOA. Save time register online at: http: /www.fdsoa.org.
Name: (fir y �f_ekn6'# Nickname:
Title: G-
Agency:
Address:
City: State: _.1_.--V Zip:
Day Time Phone: 3 7 i Z606 FAX: 7 5 7 1 26 S'
Cell Phone: 5 7 Email: g
Conference Registration Fees
Member Non Member Amount
Safety Forum Only $325.00 $425.00
Safety Forum ISO Academy $425.00 $525.00
Safety Forum HSO Academy $425.00 $525.00
ISO Academy Only $200.00 $300.00
HSO Academy Only $200.00 $300.00
X ISO Certification Exam 95.00 $195.00
HSO Certification Exam 95.00 $195.00
X FDSOA Individual Membership Dues (Join now to cake advantage of the member rate) 85.00 �bS
TOTAL AMOUNT DUE b _Q� .00
Payment Information: (U.S. Funds, drawn on U.S. Bank)
Enclosed is a check payable to FDSOA C�fEnclosed is an official Purchase Order
MasterCard Visa
Card Number: Expiration Date:
Card Holder Signature: Date:
Card Holder Name: (Please Print)
Cancellations: Cancellations must be made in writing and sent to FDSOA, P. O. Box 149, Ashland, MA
01721-0149. If received 30 days prior, 75% of Forum Registration only will be refunded; 7-29 days prior,
50% of Forum Registration only will be refunded. Less than 7 days, no refund is possible.
FDSOA Non Profit Org.
P. O. Box 149 U.S. POSTAGE
Ashland, MA 01721 --0149 PAID
Permit No. 125
Ashland, MA
OEPARPg�F
Sp,FETy
nl
r9F AI.'�' \02
Fl` �ff1GEA5
FDSOA Headquarters, P. O. Box 149, Ashland, MA 01721
Voice: 508 881 -3114 508 881 -1128 Email: membership @fdsoa.org
Incident Safety Officer Certification Application
Applicant shall meet requirements of NFPA 1521, 2008 Edition, Chapter 4, Section 4.5.1
Please type or print all information
Name: ���r� /�rr� SS# Last 4 digits: _216 9
Agency Rank: Z_
Department Type: Career Combination Volunteer Other
Address: 62 e V C vat e'
City: State: Zip:
Day Time Phone: 3 7 7 j ;26x0 FAX: 3: 7 5 7
Cell Phone: 3� —2 y/ l 6 Email: �,6rct.�r t (����e. �6 i n n �4✓
Professional Experience (Required)
Agency Dates Position
2 Oi 1 1 7 47,
T Y c1 15 ,Ae
To Employer (Required)
Please verify the above information by signing below:
verify that o has been involved in the emergency
services for a minimum of five years and meets the requirements of NFPA 1521, 2008 edition,
Chapter 4, Section 4.5.1
Print Name:
Required: Chief r Chief Officer c
Signature:
Required: hief or hief Officer
Rev. 01108
Page l of 2
Snyder, Denise W
From: Debbie Tunstill Debbie. Tunstill @thetravelagentinc.com]
Sent: Thursday, September 02, 2010 1:28 AM
To: Snyder, Denise W
Subject: Confirmed Flight for Brandt
SALES PERSON: DT2 ITINERARY /INVOICE NO. ITIN DATE: SEP 02 2010
ACCOUNT NRTXIE PAGE: 01
FOR:
BRANDT /GARY D
TO: CITY OF CARMEL CITY OF CARMEL -FIRE DEPT
ONE CIVIC SQUARE 3RD FLOOR ATTN: DENISE SNYDER
CARMEL IN 46032 TWO CIVIC SQUARE
CARMEL IN 46032
26 SEP 10 SUNDAY MILES- 828 ELAPSED TIME- 2:11
AIR LV INDIANAPOLIS 1126A AIRTRAN AIR FLT: 399 COACH CLASS CONFIRMED
AR ORLANDO /INTL 137P NONSTOP
AIRTRAN CONF MFLIQH
SEAT 18C
01 OCT 10 FRIDAY MILES- 828 ELAPSED TIME- 2:16
AIR LV ORLANDO /INTL 334P AIRTRAN AIR FLT: 394 COACH CLASS CONFIRMED
AR INDIANAPOLIS 610P NONSTOP
AIRTRAN CONF MFLIQH
SEAT 25C
*YOU MUST VERIFY ALL INFORMATION IS CORRECT. ONCE ISSUED
FEES AND PENALTIES EXIST FOR REISSUES REFUNDS- CHANGES. FOR
AFTER HOURS EMERGENCIES ON EXISTING RESERVATIONS CALL
877 6456373 CODE A09. $15.00 PER CALL FEE WILL BE CHARGED
A CANCELLATION FEE OF 15PCT ON TTL COST OF BOOKED TOURS- CRUISES
LAND HOTEL PKGS WILL APPLY. AIRLINE CHECKED BAGGAGE NOTICE
FOR DOMESTIC AND INTERNATIONAL TRAVEL AIRLINES MAY CHARGE
THE TRAVEL AGENT THANKS YOU -317 846 9619..DEBBIE WWW.TTA.TRAVEL
AIR TRANSPORTATION 173.95 TAX 34.45 TTL 208.40
PROCESSING FEE 35.00
SUB TOTAL 243.40
CREDIT CARD PAYMENT 243.40
TOTAL AMOUNT 0.00
9/2/2010
VOUCHER NO. WARRANT NO.
ALLOWED 20
Gary Brandt
IN SUM OF
$444.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# f Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 43- 430.02 $435.40 1 hereby certify that the attached invoice(s), or
1120 42- 314.00 $9.00 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
11PY t 'ten +n
Fire Chief
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 bil[(s))
FDSOA $435.40
$9.00
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