190712 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 065950 Page 1 of 1
ONE CIVIC SQUARE DIANA CORDRAY
1-� 11643 STONEY BAY CIRCLE CHECK AMOUNT: $585.88
CARMEL, INDIANA 46032 CARMEL IN 46033 -9501 CHECK NUMBER: 190712
CHECK DATE: 10113/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 585.88 IACT CONFERENCE
.0 uF C4.
X
4f
S CITY OF CARMEL Expense Report (required for all travel expenses)
NOIANA EXHIBIT A
EMPLOYEE NAME: r DEPARTURE DATE: TIME: �0-3 AM PM
DEPARTMENT: RETURN DATE: TIME:, AM
A ekewe
7J -4
REASON FOR TRAVEL: DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Taxi Tips Luggage Parking Breakfast Lunch Dinner Snacks Per Diem
L 7 6 l
O
6 °-d
Total d t) 8
DIRECTOR'S STATEM !hereby off' that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. G
Director Signature: Date:
City of Carmel Form ER06 Revision Date 3118/2009 Pagel
Hilto 1020 South Calhoun Street Fort Wayne, IN 46802
Phone (260) 420 -1100 Fax (260) 424 -7775
Fort Wayne Convention Center Reservations
Name Address www.hilton.com or 1 800 HILTONS
CORDRAY, DIANA Room 925/K1
200 SOUTH MERIDIAN STREET Arrival Date 10/3/2010 1:29:OOPM
Departure Date 10/612010
FORT WAYNE, IN 46225
US Adult/Child 110
Room Rate $114.00
RATE PLAN C -IAC
HH# 348692524 SILVER
AL
BONUS AL CAR
Confirmation: 3398189494
10/6/2010 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT
10/3/2010 1522192 'PARKING $7.00
10/3/2010 1522193 GUEST ROOM $114.00
10/3/2010 1522193 OCCUPANCY TAX $7.98
10/312010 1522193 STATE TAX $7.98
10/4/2010 1522998 "PARKING $7.00
1014/2010 1522999 GUEST ROOM $114.00
10/4/2010 1522999 OCCUPANCY TAX $7.98
10/4/2010 1522999 STATE TAX $7.98
10/512010 1523723 "PARKING $7.00
10/5/2010 1523724 GUEST ROOM $114.00
10/512010 1523724 OCCUPANCY TAX $7.98
10/5/2010 1523724 STATE TAX $7.98
WILL BE SETTLED TO $410.88
EFFECTIVE BALANCE OF $0.00
Ir IV
You have ea ed approximately 4174 HHanors points and approxi� �17�L
for this stay, o check your earnings for this stay or any other stay a any o m re an rl on
Fam
Thank you foi choosing Hilton! Book your next stay at hilton.com and take edV ntaoe of our
internet -only, A dvance Purchase Rates and limited -time special offers!
DATE OF CHARGE FOLIO NO. /CHECK NO. X7
Zip -Out Check -Out' 354443 A
Good Morning! We hope you enjoyed your stay. With "Lip -Out Check -Out® AUTHORIZATION INITIAL
there is no need to stop at the Front Desk to check out.
Please review this statement. It is a record of your charges as of late last PURCHASES SERVICES
evening.
For any charges after your account was prepared, you may: TAXES 0
pay at the time of purchase-
charge purchases to your account, then stop by the Front Desk for an
updated statement. TIPS MISC.
or request an updated statement be mailed to you within two business days,
Simply call the Front Desk from your room and tell us when you are ready to TOTAL AMOUNT
depart. Your account will be automatically checked out and you may use this 0.00
statement as your receipt. Feel free to leave your key(s) in the room.
Please call the Front Desk if you wish to extend your stay or if you have any
questions about your account.
Annual Conference Registration Form
ReE/'sfrat'{}M Deadline: September 20
p|uaoe pi nt v,type. (Register one delegate and spouse/guest per form. D x needed
Full Name First Time um" �x�
bi 4,14
Title Preferred Name for Badge
Address City orTown/State/Zip
Phone Email
Special Needs (i.e. dietary, etc.)
i Spouse/ Guest Name
Registration on/uom,� «no, suun
P Method u°"m""=°"�m^�ev e/ro/xo 9/20/10 x�ovnt m
r
Member Municipal OffhcialfPop Member Municipal Official (POPUlatiCin eSS 1110,i wm^"m^,w.�"
Associate Member
o"onCad Number
L'"`^^~``~'�� L l��������������������~
n
mm"xAdore,,
i m"o/"*x/Da /w»»«�«"/w
City or Town/ State/Zip
w"o"'G"nOuting ��ao w/^
�v�"mm.m",o�mm
°me,^ousc/w"m�,v�o�'�,/on�*/»,e' '------��----------------____---_____----_J
stnmeum those who are not municipal of-
ooia/a and who have *,professional
interest m the conference. The fee in- Pi
u/uues admission to all conference events, IDAY Welcome Par NDAY Opening Business Sesslir Is rea Awards Luncheon TUE,9DAY Breakfast
the Exhibit Hall, meals and participation /o
the guest program.
ESD
UESDAY Lunch /U AY Closing Business Session UESDAY Reception and Banquet EIDNESDAY Closing Breakfast I
Cancellation Policy Affiliate Group Events
only written uance//a lion ,~n/m, accepted. p/ ease mv// you ,wnme»oo^co//^uo^m /xcT affiliate groups will hold individual meetings and events "t the conference
200 S. Meridian m, Suite a*o' mm^napono. IN 46225; fax to<»1./>rzr'scoao, Attendees must be registered for the Conference in order mattend affiliate events.
send to lheinzrnan@cjtiesandtowns.org, Written cancellations received on or before Additional meeting and event information for affiliate group members ma oe
September 27 will ^u refunded less asoo processing fee. ]ACT /s not responsible for mailed out separately.
hotel reservations o,cancellations.
No-
ome
n place you in a to rsome or u can request to play
with certain individuals. If le, please list your desired
ut! g playing partners:
uviday uo u im
Where: Sycamore Hills Golf Club (11836 Covington Road, Fort Wayne, 46814)
Cost: $130 per person
Prior to the kick off of Sunday evening events, take a swing in this year's golf outing. Participants will play Port Wa ne'vSroamvremuoGonCluu.a
stunning Nicklaus-designed course, Please note the gotf fee is in addition to your conference registration fee. Tee-time is 9:30 a.m. Players must
provide own transportation. Lunch provided.
F C3 YES I would ay. n't forget to enter the price for golf In the registration form above ifyou would like to play�]
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.
P yee
Purchase Order No.
Terms
Date Due
Invoice Invoice Descriptlon Amount
Date Number (or note attached invoice(s) or bill(s))
K7 4 95,.
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
0 i; t�-
��6m
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. l hereby certify that the attached invoice(s), or
bili(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
f� 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund