192491 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 184595 Page 1 of 1
ONE CIVIC SQUARE TERESA LEWIS
CARMEL, INDIANA 46032 338 ORLAND OVERLOOK CHECK AMOUNT: $46.24
WESTFIELD IN 46074
CHECK NUMBER: 192491
CHECK DATE: 12/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 111710 46.24 OTHER EXPENSES
,Submit bby Ernail Print Form
Prescribed by State Board of Accounts General Form No. 101 (1955)
MILEAGE CLAIM
UTILITIES TO TERESA LEWIS 338 ORLAND OVERLOOK, WESTFIELD, IN 46074 DR.
(Governmental nit
SEWER WWTP
On Account of Appropriation No. for
ice, oar Department or nsutuhon
DATE FROM TO 50
ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE
20 Point Point Start Finish TRAVELED PER MILE
11/17/2010 WWTP 2544 EXECUTIVE DR. 74TH IWEA CONF. 14 00
11/17/2010 2544 EXECUTIVE DR. WWTP 28 56 74TH IWEA CONF." 28 14 00
Auto License No. TOTALS 0 0.00 28
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just credits, and that no part of the same has been paid.
Date I I 0
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Name ��1`_) NO'�0:��I3I.1 16 -113, 2��
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Address I�O�� t �Z l 1�i? m E
Indianapolis
1 0 City State Zip fie' s
Phone c J� Z� Email
12°IU�S�CImP_� r) 'C%Il
J 2544 Executive Drive
Indianapolis, IN 46241
ti I AM: (Please check all that apply)
Hotel Phone: 317 -248 -2481
Y
A First Time Conference Attendee An IWEA Member ALL ATTENDEES
An Elected Official* A Life Member* RECEIVE FREE LUNCH
x A Young Professional An Honorary Member*
ON TUESDAX
(under 35 years of age)
s ATumblebug
NOVEMBER 96
r A 2010 Award Winner
(received notice you are receiving an award) A Student*
pleclse ue�'�r this
z
FREE conference registration (Wednesday and Thursday lunches ®l111 f ®r i1ddit1$BllaTll
4 are not included)
CREDIT (Please mark so we may provide the appropriate form(s
need credits for:
1 Wastewater -;�7- Drinking Water Engineering
Certification Cllaasss/ /,Grade Certification Class /Grade
Cert# Cert#
hY Exp. Date 2-C) 1 Exp Date
�tfr tti THINGS TO KNOW:
All registrants must check in at the re istration desk rior to attending an session(s),
g� g p 9 Y
fk 3{ •Name badges are re for ali conference activities
L a Conference fees do not include hotel accommodation_ s Please contact the Wyndham
at 317 -248 -2481 for reservations.'
If special accommodations are needed to fully benefit from this conference, contact
the IWEA office at least one week prior so arrangements can be made.
777 v ill o r el 111 0 r ill a 011
4 64011
I www,indianawea.org /conference /index.htmi
IWEA Office: 317 686 -2664
CITY OF CARMEL Expense Report (required for all travel expenses)
\HO�pN✓
2010 mileage reimbursement rate is 50 cents /mile
EMPLOYEE NAME: Teresa Lewis DEPARTURE DATE: na TIME:
DEPARTMENT: Utilities /Sewer RETURN DATE: na TIME:
REASON FOR TRAVEL: IWEA conference DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
11/17/10 $18.24 $18.2
$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
$0.00
$0.00
0.00
Total $0.001 $0.001 $0.00 $0.00 $0.001 $0.00 $18.24 $0.001 $0.001 $0.001 $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.
Director Signature: Date:
City of Carmel Form ER06 Revision Date 11/22/2010 Page 1
VOUCHER 106637 WARRANT ALLOWED
184595 IN SUM OF
TERESA LEWIS
2985 S HONEY CREEK ROAD
GREENWOOD, IN 46143
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
111710 01- 7042 -05 $18.24
IL 1 1
Voucher Total
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
184595
TERESA LEWIS Purchase Order No.
2985 S HONEY CREEK ROAD Terms
GREENWOOD, IN 46143 Due Date 11/29/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/29/201( 111710 $18.24
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
Date U r