190773 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 363618 Page 1 of 1
ONE CIVIC SQUARE TIM GRIFFIN
CHECK AMOUNT: $729.38
•'�,;r' CARMEL, INDIANA 46032 C/0 FIRE DEPT
CHECK NUMBER: 190773
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4343002 729.38 EXTERNAL TRAINING TRA
`tiv of cAR
S
CITY OF CARMEL Expense Report (required for all travel expenses)
a
'JNO I PN P,
EMPLOYEE NAME DEPARTURE DATE: TIME: AM PM
DEPARTMENT: RETURN DATE: q- p TIME: AM PM
REASON FOR TRAVEL DESTINATION CITY:
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
9112110 $65.00 $65.00
9113110 1 $65.00 $65.00
9114/10 $65.00 $65.00
9/15/10 $65.00 $65.00
9/16/10 $65.00 $65.00
9/17110 $65.00 $65.00
9/18/10 $306.88 $32.50 $339.38
$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
Totall $0.001 $0.001 $0 00 $0.00 $0.00 $0.00 $0.00 $0.00 $422.50 $0.00
DIRECTOR'S STATEMENT: I h y i that arl ex nses eMU �fiform to the City's travel policy and are within my department's appropriated budget.
Director Signature: d Date:
City of Carmel Form ER06 Revision Date 10/7/2010 Page 1
09/18/10 1:36 AM NiteVision 2009 SP1 HF2
La Quinta Inn Suites New Britain
65 Columbus Blvd
LA QLU� .i N TA New Britain, CT 06051
INN a SUITES 860- 348 -1463
Griffin, Tim Folio 203866054
3428 eden way place Room: 302
CARMEL, IN 46033 Arrival: 09/12/10
Company: L Departure: 09/18/10
Returns Club No
Vouclier /Ship /PO:
Trans Date Descript C h a rges Payments .B alance
220508 9/12/2010 Rm: 302 BAR Best Available Rate $45.00 `$0.00 $45.00
220509 9/12/2010 TAX OCCUPANCY STATE $5.40 $0.00 $50.40
220682 9/13/2010 Rm: 302 BAR Best Available Rate $45.00 $0.00 $95.40
220683 9/13/2010 TAX OCCUPANCY STATE $5.40 $0.00 $100.80
220857 9/14/2010 Rm: 302 BAR Best Available Rate $45.00 $0.00 $145.80
220858 9/14/2010 TAX OCCUPANCY STATE 55.40 $0.00 $151.20
221059 9/15/2010 Ivn: 302 BAR Best Available Rate $45.00 $0.00 $196.20
221060 9/15/2010 TAX OCCUPANCY STATE $5.40 $0.00 $241.60
221276 9/16/2010 Rm: 302 BAR Best Available Rate $45.00 $0.00 $246.60
221277 9/16/2010 TAX OCCUPANCY STATE $5.40 $0.00 $252.00
221512 9/17/2010 Rm: 302 BAR Best Available Rate $49.00 $0.00 $301.00
221513 9/17/2010 TAX OCCUPANCY STATE $5.88 $0.00 $306.88
Balance: $306.88
Method of Pay:
Signature:
THANK YOU
WE APPRECIATE YOUR BUSINESS
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The purpose of the IAFF- [AFC -ACE PFT certification program is to provide a fitness
trainer standard consistent with the health and fitness needs of the Fire Service throughout.
the United States and Canada. The Peer Fitness
Trainer (PF 'I') program was created so interested
a. fire department personnel could obtain certification
In fitness= program design and implementation in a
F` order to help their peers with their fitness programs
tiij; a on a one -on -one basis and to help with the physical
training of recruits. Those successfully passing the
t certification exam will have demonstrated they pos-
sess the knowledge and skills required to design and
dN a n implement fitness programs, improve the wellness r
and fitness of the uniformed members in their de-
part:ments, assist in the physical training of recruits,
and assist the broader community in achieving well
5y`k" ness and fitness.
The class consists of a five -day PFT workshop to
assist the candidate in successfully achieving certi-
r fication. The class must consist of a minimum of
25 students or cancellation of the class is manda-
tory. The American Council on Exercise (ACE) is the certifying organization that awards the
IAFF /IA'FC /A.CE Peer Fitness Trainer Certification to candidates successfully passing the
certification exam. Class hours: 40 i
Eligibility Requirements: In order to be eligible to take the PFT examination you must be a 1,
firefighter, EMS provider, or employed b a fire dep artment and involved in a fitness p ro-
3.
g P Y p� p
gram. Examination candidates must possess a valid CPR certification by the day of the ex-
amination. For additional information look on the IAFF website under
Programs Services Health and Safety >Wellness and Fitness> Peer Fitness.
Class Materials: Workout Clothing, Bring All Study Materials.
Fee: $700.00 Per Person includes Books, Class and Certification Test
iVlondav— Fridav 0800 -1700 hrs For General and Lodoing Information
Location: New Britain Fire Department Contact: Bill DeFord
Host at Central Connecticut State Univ. Cell: 860 -916 -0588
1615 Stanley Street Office: 860 -627 -6363 ext. 343
New Britain, CT 06051
(Location on campus TBi7)
t�
C'r»zruc'l M f(u•rrrrrliour rrd
Aliplicaliorf urt Back
Student Application
A separate application is required for each course, ,r Your lD Consist of cite Ftrst (3) Letters af'your last pzme
and La %(4} nua>itiei af,your stxta! securihy number.
Please prinVtype and mail /fax with payment to:
ID Number•
CFPC, 34 Perimeter Road, Windsor Locks, Cr 06096 -1069 Example lohr Adams S5 tt {300 00 5555
Fax (860) 654 -1889 The new ID will be'ADA -5555
Last Name i F¢ As Chief of the
First Name
Fire Department or as Supervisor of the
r
Home Address
2 3 EDEN Vi Y Pi. organization,
I nereln authorize tie abcve app[iart to participate in me pragram below and, therefore, understand tnat
me p'os'e named individual trill be ccveced by m organiznorn's Worker's Compensation Insurance while
paridDaiing in such training, and [hat the Cnanm ssion on Fire Prsenuon and Control, its crmrriisstoners,
eor ers, agents er emplapc shall not be liable for any injuries sustained during such training.
This aopl cart is ccn5ideied by ny department's standards t.; be physica4 and mati%alfy fii io perform
t;,eSohtE evola ans w shout spec al considerations, and where aCpl cable, to meet the 29 CER 191C,13-
city Q� L standard for t e use of resp' ators tSeli- Conlair:ed SEeathing A pata:us).
Chief or Supervisor Signature
L No applica cn avll be accep ed .viIheut to stun, ahe:ired vonawre and proof or prerequisite {1f needed}.
State T Zip t0 �J 3
f� pp 0i Proof included. Regist_r me for the following course:
Phone (Home) SO 2 U
Course Title
Work r30) `1) S 7 `2 Course r a
Cell 7 J Z S l Date(s) Tuition
Method of Payment Payment is required at time of registra-
Pager tion. Faxes must include Credit Card or Purchase Order
Fire DepartmenVor anization A Q gA f L F R 1 D E r 1 100 Check made payable to CFPC
0 Purchase Order
Email
OVISA MasterCard Card
i_.1 Check box if you would like to subscribe your e -mail address
to the CFPC listserve.
Card Holder's Name:
Are you 18 years of age or older? 1` Yes No
(No one under 18 is allowed to participate in hands -on programs) Card Holder's Signature: Exp. Date:
Page 1 of 2
Snyder, Denise W
From: Debbie Tunstill Debbie. Tunstill @thetravelagentinc.com]
Sent: Thursday, August 12, 2010 3.59 PM
To: Snyder, Denise W
Subject: Confirmed Flight for Timothy Griffin
SALES PERSON: DT2 ITINERARY /INVOICE NO. ITIN DATE: AUG 12 2010
ACCOUNT MM80P9 PAGE: 01
FOR:
GRIFFIN /TIMOTHY M
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
12 SEP 10 SUNDAY MILES- 587 ELAPSED TIME- 1:50
AIR LV INDIANAPOLIS 650A US AIRWAYS FLT:3350 ECONOMY CONFIRMED
AR PHILADELPHIA 840A NONSTOP
RESERVED SEATS 8D
AIRLINE CONFIRMATION:US 3K7X07
MILES- 157 ELAPSED TIME- 1:08
AIR LV PHILADELPHIA 1005A US AIRWAYS FLT:4526 ECONOMY CONFIRMED
AR NEW HAVEN 1113A NONSTOP
RESERVED SEATS 6C
AIRLINE CONFIRMATION:US BK7X07
18 SEP 10 SATURDAY MILES- 157 ELAPSED TIME- 1:15
AIR LV NEW HAVEN 720A US AIRWAYS FLT:4297 SPECIAL CL CONFIRMED
AR PHILADELPHIA 835A NONSTOP
RESERVED SEATS 7D
AIRLINE CONFIRMATION:US BK7X07
MILES- 587 ELAPSED TIME 2:09
AIR LV PHILADELPHIA 1010A US AIRWAYS FLT:3179 SPECIAL CL CONFIRMED
AR INDIANAPOLIS 1219P NONSTOP
RESERVED SEATS 9D
AIRLINE CONFIRMATION:US BK7X07
CONF US BK7X07
THIS IS AN ELECTRONIC TICKET. PLEASE PRESENT PHOTO
ID AT CHECK IN WITH AIRLINE CONE. TICKET IS COMPLETELY
NONREFUNDABLE IF UNUSED. MAY CHANGE ONLY PRIOR TO ORIGINAL
TRAVEL DATE. FEES WILL APPLY.
10/7/2010
VOUCHER NO. WARRANT NO.
ALLOWED 20
Tim Griffin
IN SUM OF
$729.38
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE N0. ACCT /TITLE AMOUNT
Board Members
1120 43- 430.02 $729.38 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
UL, I X 12010
Ij
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 bill(s))
Peer Fitness Class $729.38
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