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HomeMy WebLinkAbout191226 10/27/2010 "F CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1 ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $1,863.94 CARMEL, INDIANA 46032 C/O DEPT OF LAW C 0 DEPT of LAW CHECK NUMBER: 191226 CHECK DATE: 1 012 712 01 0 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343002 1,863.94 EXTERNAL TRAINING TRA G t l of CggM� pSXTl k,� I CITY OF CARMEL Expense Report (required for all travel'expenses) hNDIpNp EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 09/26/10 TIME: 4:30 p.m. DEPARTMENT: Law Department RETURN DATE: 09/29/10 TIME: 7:15 p.m. REASON FOR TRAVEL: PLI Seminar DESTINATION CITY: New York City, New York EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas /Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem $0.00 Sept. 26 29, 2010 $215.10 $72.00 $72.00 $1,277.34 1 $260.00 $1,896.44 $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 41 L 0.00 Total $215.10 $0.001 $72.00 $72.001 $1,277.341 $0.00 $0.00 $0.001 $0.001 0 $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. (g Director Signature: Date: City of Carmel Form ER06 Revision Date 10/8/2010 Page 1 STATE OF INDIANA SS: COUNTY OF HAMILTON AFFIDAVIT I, Douglas C. Haney, Carmel City Attorney, being first duly sworn upon my oath, state that I while on City business attending a PLI seminar in New York City on Section 1983 law from September 26 29, 2010, 1 expended $72.00 of my own money for parking at the Indianapolis .International Airport and for which. I need to be reimbursed. Dated this �,j day of October, 2010. Dou Subscribed and sworn to before me, the undersigned Notary Public, this of October, 2010. Cc�rlc�J• NOTARY PUBLIC Resident of County, Indiana My Commission Expires: a [eb:rtisuord:z:\shivcdamdx citsdFudivil- parkifl. dce: I Q5 /I9J 1335 Avenue of the Americas New York, NY 10019 Phone (212) 586 -7000 Fax (212) 261 -5946 H ilton Reservations Name Address New York www.hilton.com or 1 800 HILTONS HANEY, DOUGLAS Room 3326/D2D 13828 SMOKEY RIDGE DR Arrival Date 9/26/2010 4:40:OOPM Departure Date 9/29/2010 12:01:OOPM I CARMEL, IN 46033 -9101 Adult/Child US Room Rate 368.00 RATE PLAN L -LS c Z HH# AL: DL #061240012 BONUS AL: CAR: CONFIRMATION NUMBER: 3388069135 9129/2010 PAGE 1 DAT D ESCRIPT I ON ID REF, NO CHARGES CRED ITS BALANCE 9/26/2010 GUEST ROOM SROSA 16767340 $368.00 9/26/2010 STATE ROOM TAX 8.875% SROSA 16767340 $32.66 TheHilWnF uigy 9126/2010 ROOM OCCUPANCY TAX SROSA 16767340 $21.62 5.875% 9/26/2010 $2.00 CITY TAX SROSA 16767340 $2.00 9/26/2010 JAVITS CTR FEE SROSA 16767340 $1.50 Hilton 9/27/2010 GUEST ROOM SROSA 16773691 $368.00 9/27/2010 STATE ROOM TAX 8.875% SROSA 16773691 $32.66 9/27/2010 ROOM OCCUPANCY TAX SROSA 16773691 $21.62 5.875% coNRAa 9/27/2010 $2.00 CITY TAX SROSA 16773691 $2.00 9/27/2010 JAVITS CTR FEE SROSA 167,73691 $1.50 9/28/2010 GUEST ROOM SROSA 16776927, $368.00 912812010 STATE ROOM TAX 8.875 $RgSA 16778927 $32.66 `I I_ DOU A LETR[e AX 8/28/2010 ROOM OCCUPANCY T; SROSA 'z16778927 $2I 62 5.875% u, t 912812010 $2.00 CITY TAX SROSA 16778927 $100 9/28/2010 JAVITS CTR FEE SROSA 16778927 ,$1.50 912912010 TSANGA 16781347 $1,277.34 ••T• BALANCE $0.00 Hilton Hilton HHonors(R) sta are posted within 72 ho rs of checkout. To heck Hilton your earnings for this o any other stay at more t an 3, 000 Hilton Fa ily hotels worldwide, plea a visit HiltonH li onors. cor 7. Grand Vacations Club' ACCOUNT N0, DATE OF CHARGE FOLIO NO.ICHECK NO. /26/2010 2673436 A 211119 fChTuoon suRFs CARD MEMBER NAME AUTHORIZATION INITIAL HANE DOUGLAS 469823 ESTABLISHMENT NO. &LOCATION ESTARLISHMENTAGREE STpTRANSMO `TG CARD HOLDER FOR PAYMENT PURCHASES SERVICES U TAXES Official Sponsor TIPS MISC. TOTAL AMOUNT MERCHANDISE AND/OR SERVICES PURCHASED ON THIS CARD SHALL NOT HE RESOLD OR RETURNED FOR A CASH REFUND. PAYNIENT DUE UPON RECEIPT L INVOICE Order/ Invoice Number Order Date O 0 810 Sc%'enth Avenue 1 V l l� 1476032 06/15/2010 P L 1 New fork, 10019 er 873092 NftACTIju:G L�'•V IN $TRUTF. fel (800 260.4754 Customer Numb HAS.: (81111) 321-11093 PAYMENT INFORMATION' Total Amount Due I Enclosed is my check payable to Practising Law Institute $1,595.00 Please charge my payment to my Amex Visa Mastercard Diners Club *1'lcu.cc rvrifc the nnruuur rrf our prrvnrcnr !u•rc Credit Card No.: Expiration Date: Cardholder Name: Cardholder Signature. SOLD TOE Douglas Haney SHIP TO: Douglas Haney City of Carmel City of Carmel 1 Civic Sq 1 Civic Sq Carmel,IN Carmel,IN USA 46032.7569 USA 46032 -25x4 Has your address changed? if so, please check here 0 and Fitt out your new address on the back of this stub. Ple iseiferach al perforaiiov, roiafn the bonorri poilion for your records, and return the top portion witir your paymeni in the envciope provided Order Date Order! Invoice Number Customer Number Customer PQ Number PAYMENT DUE ON RECEIPT 06/15/2010 1476032 873092 Ordered By Douglas Haney Registration Number 286695 Page 1 of I Ref No. ITEM'NOdENTITY SUB TYPEIDESCRIPTION OTY UNIT PRICE DISCOUNT TOTAL 1538541 23406- Program -Empl Inst 2010 NY 1 $1,595.00 $0.00 511.595.00 Within 30 days of receipt, if, for any reason, you are not satisfied with your merchandise, please call our Customer Service department at (800) 260 -4754 Total Discount Sub Total $1,595.D0 and you will be sent a pre -paid return label, Please see the reverse side of this $0.00 Coupon $0.00 invoice regarding the return of any item in this order. Sales Tax 5D 00 AFTER 30 DAYS, SEMINARS AND PRODUCTS ARE DEEMED TO BE ACCEPTED AS IS Shipping 50.00 AND ARE NOT REFUNDABLE. Paid $0.00 e o Total Due PL i $1,595.00 NRACIISING I AW IN51!'IVrF. 810 Seventh Avenue o New York, NY 10019 Tel.: (800) 260 -4754 Fax: (800) 321 -0093 Visit our website at vvww.pli.edu -o INDIANA RETAIL TAX EXEMPT PAGE of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER 0 f F 4n FEDERAL EXCISE TAX EXEMPT �3 P�� r� A NT CA 35- 60000472 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLI SHIPPING LABELS AND ANY CORRESPONDEN ROVED BY STATE BOA OF ACC OUNTS FOR CITY OF CARMEL 1997 CHAS ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO, DESCRIPTION 7 ENDOR SHIP 9J0 U TO I AIX /001 1F1RMAIION BLANKET CONTRAO� PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION ri •Gd I t �1 3 I V, 5 40 Send Invoice To: PLEASE INVOICE IN DUPLICATE DE PARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT PAYMENT A ll ..5/5 OCR A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.D. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND f VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS 4 .�ij I HEREBY CERTIFY THAT THERE IS AN UN08LIGATED BALANCE IN THIS APPROPRIATION SUFFICtENTTD PAY FOR THE ABOVE ORDER. C. .D. S PAID. HIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SNIPPING LABELS. 1 THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER VOUCHER NO. WARRANT NO. ALLOWED 20 Douglas C. Haney IN SUM OF 13828 Smokey Ridge Drive Carmel, IN 46033 6.44 ON ACCOUNT OF APPROPRIATION FOR Carmel Law Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1180 I I 43- 570.02 $J,8e6-4-4 I hereby certify that the attached invoice(s), or Q f 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 Monday, October 25, 2010 hector, Law Department 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)) 10/25/10 $1,896.44 1 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