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HomeMy WebLinkAbout192831 12/15/2010 VENDOR: 120950 F CITY OF CARMEL, INDIANA Page 1 of 1 ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $3,759.78 CARMEL, INDIANA 46032 C/O DEPT OF LAW C/O DEPT OF LAW CHECK NUMBER: 192831 �o CHECK DATE: 12/15/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 4359003 9.74 CLEAN SANTA SUIT 1180 4128000 1,961.93 TUITION REIMBURSEMENT 1180 4343002 177.75 HOTEL —INDY ISBA 1180 4343002 947.94 NLC— DENVER 2010 1180 4343003 16.92 VARIOUS RECEIPTS 1180 4343004 130.50 MILEAGE 1180 4357004 515.00 NLC DENVER 2010 4�lQpas OF C� ,El. A CITY OF CARMEL Expense Report (required for all travel expenses) �1NpiaN? EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 10/14/10 TIME: DEPARTMENT. Law Department RETURN DATE: 10/15/10 TIME: REASON FOR TRAVEL: ISBA Annual Conference DESTINATION CITY: Indianapolis, Indiana 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 Oct. 14 -15, 2010 $14.00 $154.50 $8.16 $1.09 $177.75 $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 $0.00 $0.00 $0.00 $14.00 $154.50 $0.00 $0.00 $8.16 $1.09 $0.00 $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: I> City of Carmel Form ER06 Revision Date 12/812010 Page 1 Attention: Hampton Guest 105 S. Meridian St. Indianapolis, IN 46225 If the debit /credit card you are using for check in is attached to a bank or checking account, a hold will be placed on the account for the full anticipated Phone (317) 261 1200 Fax (317) 261 1030 dollar amount to be owed to the hotel, including estimated incidentals, www.hamptondt.com through your date of check -out and such funds will not be released for 72 hours from the date of check -out. Initial: HANEY, DOUGLAS name address room number: 303 1KXPL 13828 SMOKEY RIDGE DR arrival date: 10/14/2010 6:41:OOPM CARMEL, IN 46033 departure date: 10/1512010 Initials adult /child: 1/0 room rate: 132.05 Initials RATE PLAN S -AAA HH# AL: CAR: The management is not responsible for any valuables not secured in safety deposit boxes provided at CONFIRMATION NUMBER: 80474063 the front office, nor theft or damage to vehicles parked on the premises. I agree that my liability for the charges is not. on and agree to be held personally liable in the event at the indicated person, company or assocaton fails to pay for any part of the full amount of such charges. I hearby agree to vacate the accommodations assigned by 12 noon on the departure date printed above after that time authorize you to remove my property thereof and release you from any liability from any removal. 1 011 5/201 0 PAGE 1 "I have requested weekday delivery of USA TODAY. If refused, a credit of $0.75 wilt be ap plied to my account." In the event of an emergency, I or someone in my party, require special evacuation assistance due to a physical disability. Please indicate yes by checking here: signature: 10/14/2010 1537525 VALET PARKING $14.00 10/14/2010 1537544 GUEST ROOM $132.05 10/14/2010 1537544 ROOM TAXES $22.45 10/15/2010 1537672 ($168.50) BALANCE $0.00 EXPENSE REPORT SUMMARY 0 00:00:00 STAY TOTAL ROOM TAX $154.50 $154.50 MISCELLANE DUS $14.00 $14.00 DAILY TOTAL $168.50 $168.50 4 _f� p �vy� t°chec. r� 9 hat �yourearLin� sifo or Panlotheskt�oas {5i�� y 56F�'Ir7t3f r i2�9 okftsd�rs��1s,].'►�'ffl'�COm.- account no. STAY IN TOUCH WITH US IN BETWEEN STAYS! FOLLO VUSLON dfk•$(IJTER Hf@WdKMIEW). AND LIKE US ON FACEBOOK (FACEBOOK.COM /RAMP N). dMolm 2010 6:4 :00 420528 A card member name authorization initial HANEY, DOUGLAS 01499Z establishment no. and location esWb11.hm t agrees —1-t gab h °me, W, °arms °c purchases services taxes tips mist. signature of card member X total amount 168.50 TheHilt&iffim l C ton Doua eam" "M th anks y I HII�.ETaee ®Gartlenlnxr REGISTRATION FORK! Name: DOU G i-- A 5 C. A��y [ffi1C�'I1 C l T V Address C 4 ulG ,SCIl City: Z State: 7PJ Zip: 1 16 0 3 E -mail: d h Phone: 31-7- S -aV 22 Fax: 3/7 New Cont info. Please update my record. FULL -TIME REGISTRATION Early Bird 9/24 After 10/8 Total ISBA Member $275 $325 $375 ISBA Member Licensed Less Than 5 years $140 $190 $240 ISBA Member Judge $175 $225 $275 ISBA Affiliate Membership $95 $145 $195 ISBA Member Law Student $25 $50 $75 Non Member $560 $610 $660 Full -time registration fee includes: President's Late Night Social, Wednesday ISBA Law Expo, Friday Ao Breakfast, Thursday and Friday Break Stations, Law School Receptions, President's Reception on Thursday and attendance at any Section /Committee CLE Program. Up to 26 hrs CLE (including 2.5 hrs of CME and 6 hrs of Ethics) plus 3.5 hours of NLS are being offered throughout the Annual Meeting! PART-TIME REGISTRATION Early Bird 9/24-10/8 After 10/8 Total ISBA Member Single Day $150 $175 $200 ISBA Member Single Day includes CLE programming, Law Expo (Sr Friday Breakfast President's Reception, if applicable). Y Check which day you plan to attend: Jhursday, October 14 Friday, October 15 ISBA Member Single Program $40 $60 $75 ISBA Member Single Program includes attendance at one Section or Committee CLE Program of your choice. Please indicate the program you will be attending: GUEST REGISTRATION Early Bird 9/24-10/8 After 10/8 Total Guest Registration $50 $65 $80 Guest Name: Guest Registration includes attendance at the President's Late Night Social (Wed.), Law School Receptions, President's Reception Tours.), Friday Breakfast br the Law Expo. SPECIAL EVENTS You must pre register for the special events below. Walk ins will be accepted on a space available basis. Thursday, October 14 ISBA Awards Luncheon: $25 each ($40 on -site) President's Dinner: $60 each Additional Ticket ($70 on -site) President's Reception: $20 each Additional Ticket ($40 on -site) (President's Reception is included in the full -time, Thursday single day and Guest registrations.) Friday, October 15� Association Assembly Luncheon: $25 each ($40 on -site) Randall T. Shepard Award Reception Dinner: $60 each TOTAL: A S PuftKlip_ Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 Douglas C. Haney Purchase Order No. 13828 Smokey Ridge Drive Terms Carmel, Indiana 46033 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12 -8 -10 Reimburse Douglas C. Haney for monies he personally $177.75 expended while participating in the ISBA Annual Conference held Oct. in n ianapo is, Indiana, attached L.APUI IOU I I port and receipts s Total $177.75 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 Douglas C. Haney IN SUM OF 13828 Smokey Ri dge D rive Carmel, Indiana 46033 $177.75 ON ACCOUNT OF APPROPRIATION FOR Department of Law 430 -43002 External Training Travel Board Members o 1t INVOICE NO, ACCT #fTITLE AMOUNT I hereby certify that the attached invoice(s), or 1180 $177.75 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 20/6) dog gnature T' Cost distribution ledger classification if claim paid motor vehicle highway fund ncnz3un ranv.n� tlar•ket Square Center Denison Par•liing, Inc. Insert Harcnde up When Paying at Pay Station Iirkct# 11058751411 Entered :'2010/10/19 15:09 Paid (In 21110/10/19 16:32 Duration: 88:06 .Paid 5.DO Drg. Fee: 5.011 Fee File: 1 Credit 0.110 Credit Card: 1111111 Illorm Drive out time until 16:47 1. thank- You ..Come Again .NW %NYM....m Seeped Purchase 10/10/19 16:32:S6 Segii PUF Authil 019422 000 APPHHUFII O WORLDWIDE PA.AKMC,SOLUTiOk$ aoa r L-i WORLDWIDE PARKING SGLUTION5 KEEP THUS El El 1 F�g ED u WORLDWIDE PARKMG SOLUTIONS 16 Meridan starting 2/25/10 24 HOURS THUR -SAT www.hiringtowin.com promotion code= MCD04407C 1611 N MERIDAN ST INDIANAPOLIS, IN 46202 THANK YOU MCDONALDS TEL# (317)920 -1258 J 30 KS #14 1 I Jun.09'10(Wed)20:56 STORE# 4407 '1 ANGUS MSHR &SV)IS MEAL 4.89 1.LR6 DIET COKE 1.00 SUB TOTAL 5.89 TAKE OUT.TAX 0.53 6.42_ CASH TENDERED 20.00 CHANGE 13.58 043263 ROOM b DYAOUNT V4 jz;WV INN HOTELS R RESORTS DEPARTM T DO NOT WRITE IN AB NA P 0 L I S DATE v NAME OTFI. UITY ENIRE ROOM OR j 3 1 W t s T U H t 0 S T R E E T ACCT. NO. j T9 1 NOT WRITE IWTHIS SPACE EXPLANATION !�i it I p FORM NO. 62 MISC. CHARGE SIGN RE STATE OF INDIANA SS: COUNTY OF HAMILTON AFFIDAVIT 1, Douglas C. Haney, Carmel City Attorney, being first duly sworn upon my oath, state that I while on City business attending a Legislative Committee Meeting at the Statehouse in Indianapolis Indiana on January 12, 2010,1 expended $3.25 of my own money for parking and for which I need to be reimbursed. Dated this day of December, 2010. Douglas C. Haney Subscribed and sworn to before me, the undersigned Notary Public, this g day of December, 2010. c 11 A. Elaine Bass, NOTARY PUBLIC Resident of Marion County, Indiana ,My Commission Expires: .F October 23,'201 Leh: m -ord zasharcd�. iffidavas\affadiva -parking .doc:12 /8 /10 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 Douglas C. Haney Purchase Order No. 13828 Smokey Ridge Drive Terms Carmel, Indiana 46033 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12 -8 -10 Reimburse Douglas C. Haney for monies he personally $16.92 expended for parking and food while on City business per the attached receipts and affidavit Total $f6.92 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 Douglas C. Haney IN SUM OF 1 S mokey Ridge Drive Carmel, Indiana 46033 $16.92 ON ACCOUNT OF APPROPRIATION FOR Department of Law 430 -43003 Travel Lodging Non Training Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1180 $16.92 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 JO V &aL j 20/0 Signature Cost distribution ledger classification if claim paid motor vehicle highway fund PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986) MILEAGE; CLAIM TO n (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR ,,,lY/ .f1LCY/1'77�J (O FICE, OA D, DEPARTMENT OR INSTITUTION) DATE FROM TO SPEEDOMETER AUTO MILEAGE READING D POINT POINT START FINISH NATURE OF $USINESS TRAVELED -5 x PER M 1 rw� y a 7 10 Y 3 S 1 7 -5 0 15 10 '7o 3s o o f. 0 0 157 no AUTO LICENSE NO. TOTALS 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, I 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 Claim No. Warrant No. I have examined the within claim and hereby IN FAVOR OF certify as follows: That it is in proper form. C That it is duly authenticated as required by law That it is based upon statutory authority. That it is apparently correct (f incorrect y3o Disbursing Officer On Account of Appropriation No 73QO for q r o CL 0 a 9U m o m Cb y Allowed 19 ]n_ W o a w in the sum of d En m a m m E g a N En o m N@� O n e (Board or Commission) O am w FILED f a M a a rt M (Official Title) O W m N r m A.E. ROYCE CO., INC. MU3JCtE, Qi 02 134S C6 MO re "H i s tf a' e r s 14 S,---Range I i ne. Rd Car'm'et) IN 46032 3 17 8 46' 7.756 HANEY, TAMMY (317)843--2962 DUE Fri 1 /26 Emp„ A 11/22 06_03 PM Ma Garment Pcs, T o I Pants 1 6.99 Sweater 1 6.99 f, 1.2.99 gtANTA SUIT 12. ��otal:,$39.96 Less $10.00 -:,Jak: $0.00 HANG/ Gr. Total; $29-96 Re I ci !,'I 3 5°I Do 3> VOUCHER NO. WARRANT NO. ALLOWED 20 Doug Haney IN SUM OF 13828 Smokey Ridge Drive Carmel, IN 46033 $�9 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1160 Receipt 43- 590.03 I 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 Friday, December 10, 2010 r Mayor 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)) 11/22/10 Receipt $12.99 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head np for to commencement of course.) Employee Name Des QS �4ati e� Department L-CtL SSN Hire Date O) 2e 9 Educational Institution* C X -14 00 (Jt I tY Name of Course ,1e-�_ i"zxi, Aeff"'o 4S Credit Hours Starting Date of Course (month/day /year) 9'/0 -7 l By signing below, I signify that I understand the following: °j o/ 93 WX 4 1 3 o The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -58. To receive reimbursement for tuition, 1 must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I trust submit an original itemized receipt or other proof of purchase that links these books to this particular course. If I leave City of Carmel employment sooner than one (1) year after the end of this course, 1 will repay the City in full for its tuition and book reimbursements for this course. a The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature Date dg Part IT (to be completed by Department Head) (Submit to Human Resources) By signing below, I certify that the applicant will have been employed full. -time by the City for at least one (1) year prior to the commencement of the course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the beginning of the course. The final claim will be paid from my department's budget, subject to the terms of Section 2 -58 of Carmel City Code. Department Head Signature Date 1, --Z 3 Part III (to be completed by Director of Human Resources) Final Approval Date If denied, reason for denial The tuition reimbursement program covers only full- semester courses offered through a degree granting institution accredited by the North Central Association of Colleges and Schools or an equivalent regional accrediter. An application will not be considered complete unless a course description from the school's literature is attached. Account Detail for Term Page 1 of 1 Review detail transactions on your account, including current and future balance totals for the selected term and other terms. Please Allow 24 Hours for payments to be posted to your account. 201110 2010 Fall Qtr 09 107-11128 Term Detai/ Detail Code Description Charge Payment Balance �l iCPo PhD in Public Policy Admi 20.00 Aid Uv TFEE Walden Technology Fee 0 Current Term Balance $1. Current Balance for Other Terms: 1860.00 Future Balance for Other Terms: $4,135.00 Total Account Balance: $4,135.00 Includes future and previous term balances. https: /ssb.waldenu.edu /pls/ PROD /bwskoacc.P_ViewAcetTerm ?term iii= 201110 11/30/2010 StudentView Page 1 of 2 View Gradebook Help View Gradebook User Activity My Gradebook: Douglas Haney Grade To Date: 97.40% View Gradebook By: Week I Item Percentage of Final Gra Points Earned to Date Poss Week 1: Developing a Research Mind -set Discussion 1 20120 4% Week 1: Developing a Research Mind -set Discussion 2 20/20 4% Week 2: Becoming an Ethical Researcher Discussion 1 20/20 4% Week 2: Becoming an Ethical Researcher Discussion 2 20120 4% Week 2: Becoming an Ethical Researcher Pre Assessment 25/25 4% Week 3: Concepts, Statements, and Forms of Theory Discussion 20120 4% Week 3: Concepts, Statements, and Forms of Theory NIH 25125 4% Week 4: Testing and Using Theory Discussion 20/20 4% Week 5. Literature —The Starting Point for Research Discussion 20/20 4% Week 5: Literature —The Starting Point for Research Theories 25/25 5% Week 6: The Introduction Problem, Significance, Purpose Discussion 20/20 4% Week 7: Research Questions and Hypotheses Discussion 20120 4% Week 8: Quantitative Research Design and Methods Discussion 20/20 4% Week 8: Quantitative Research Design and Methods Bibliography 33/35 6.60% Week 8: Quantitative Research Design and Methods DRAFT Quantitative Plan 7/1 1.40% Week 9: Qualitative Research Design and Methods Discussion 20120 4% Week 9: Qualitative Research Design and Methods DRAFT Qualitative Plan 10/10 2% Week 10: Mixed Methods Research Designs and Methods Discussion 20/20 4% Week 10: Mixed Methods Research Designs and Methods DRAFT Mixed Methods Plan (9/10 1.80% Week 11: Presenting Research Findings Discussion 20/20 4% Week 11: Presenting Research Findings Three Plans 46150 9.20% Week 12: Evaluation Research Discussion 20/20 4% Week 12: Evaluation Research Post Assessment 37/40 7.40% Total 97.40% (of 100% Completed) Grade To Date: 97.40% Gradebook Key Items not yet graded Exams not yet entered Extra Credit Excluded from Course Grade Bold values indicate all items have not been graded. To access grade details and comments click on the or on the grade. The grade to date shown above includes only the items that have been graded thus far ---it does not take into account ungraded items. http:/ /altone.gradebook.ecollege.com/ Manager /StLidentView .aspx ?GUID= 5Ppk$199$03 o... 11/30/2010 0 IR Order Number: 13407964 Ship To: DOUGLAS HANEY P.O. BOX 597 LLC Order Date: 8/16/10 13828 SMOKEY RIDGE DR COLUMBIA, MO 65205 Order Time: 11:13:59 CARMEL IN 46033 -9101 317 571 -2472 317- 843 -2062 Internet Ordering for WALDEN UNIVERSITY ONLINE at http /booksto mbsdirect ne /waldenoni1ne,htm 'ORDER .SUMMARY SHIP QTY C N AUTHOR T I TLE. u. ED.I T I:ON____ COST— 1 7 N CRESWELL Research Design 3RD 09 63.75 978 -1- 4129 6557 -6 CLASS RSCH -8100P 1 N LAUREATE EDUC. Primer in Theory Construction >CUSTOM< 10 27.50 978 0 558 55147 -6 CLASS- RSCH -8100P 2 20-1— p r� k�.: a`sw H a x s.g, a,V:, a�;(� s �k 2�i y InP r+Y M a A j„�;Qa A, e,}�!°1fe1�' `''�r..-� a .r a NO 91 .25 ups seourm 10.68 .00 101.93 Returns CASH for Books! if you are not pleased with your purchase, simply ship it back to us within 14 days of When you are finished with your book, SELL ITTO US! To sell your books, visit delivery, or 14 days after the first of class, whichever is the later, for a full refund http: /www.mbsDirecLnet/Buyback and log in to create a buyback quote. Insured shipping methods are recommended. All items must be received in original You will receive a pre -paid shipping label so you may send us your books for condition with shrink wrap intact, Bundled items must be returned with all free! You can also save this box to send us the books you wish to sell back. components. Refund will not include your original shipping or return shipping fees. Additionally, if you've purchased books from us before, you may be eligible for a Buyback Loyalty Bonus. Please note: buyback services are provided by MBS IMPORTANT NOTICE: eContent products /access codes are NON RETURNABLE upon Service Company, Inc. (MBS) activation. ff you purchased this product in error, please contact MBS Direct immediately at tier2support@mbsbooks.com. The return policy is effective for Contact Information products /codes not activated for 14 days after the order is placed or class start date, Contact us at vb @mbsbooks.com or call toll -free at 800- 325 -3252, 24 hours a whichever is later. day, 7 days a week. Ci INDIANA RETAIL TAX EXEMPT PAGE of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 41w 35- 60000972 1 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. V NO. DESCRIPTION /0 VENDOR `°j SNIP TO CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION n f_ wV °'alp° �a�.• Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT_ PROJECT ACCOUNT Q AMOUNT 7, c X000 PAYMENT f/ A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. ti 4�CG4 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS- THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 15 A P.V. CLERK TREASURER DOCUMENT CONTROL NO. COPY SIGN AND RETURN TO CLERK OFFICE VOUCHER NO._ WARRANT NO._ ALLOWED 20 IN THE SUM OF S C/1 N ACCOUNT APPROPRIATION FOR Board Members P� INVOICE NO, ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or 3 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 T 2a -j' 0 _u re Title Cost distribution ledger classification if ciaim paid motor vehicle highway fund 4` 1y OF CA-94 TQn xTrg i CITY OF CARMEL Expense Report (required for all travel expenses) IHUTANA EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 12/02/10 TIME: 6:30 a.m. DEPARTMENT: Law Department RETURN DATE: 12/04/10 TIME: 5:45 p.m. REASON FOR TRAVEL: National League of Cities DESTINATION CITY: Denver, Colorado 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 Dec 2 4, 2010 1 $228.80 $36.00 $54.00 $434.14 $195.00 $947.94 $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 $228.80 $0.00 $36.00 $54.00 $434.14 $0.00 $0.00 $0.001 $0.00 $195.001 $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 12/6/2010 Page 1 Hilton Garden Inn 1400 Welton Street Denver, 25-2 Phone (303) 603- 8000 •Fax (303) 3) 825 -2255 Denver Downtown Reservations Name &Address 'wtivNv.IICiLcom or 1 877 STAY HGI HANEY, DOUGLAS Room 9141K1JZ 13828 SMOKEY RIDGE DR Arrival Date 12/212010 Departure Date 4:10: 12!4/2010 8:41:O OAM I CARMEL, IN 46033 -9101 Adult./Child 2/0 US Room Rate 189.00 RATE PLAN L -AA C HH# 864254159 DIAMOND AL: DL #6061240013 CAR: CONFIRMATION NUMBER: 3408027079 12/4/2010 PAGE 1 DATE DESCRIPTION ID REF. NO QHARGES CREDITS BALANCE 12/2/2010 GUEST ROOM DEW 688357 $189.00 12/2/2010 RM CITY LODGING TAX DEW 688357 $20.32 TheHilltoFamily 12/2/2010 RM STATE TAX DEW 688357 $7.75 12/3/2010 GUEST ROOM DEW 688933 $189.00 12/3/2010 RM CITY LODGING TAX DEW 688933 $20.32 12/3/2010 RM STATE TAX DEW 688933 $7,75 Hilton VAM 689897 ft. 79 12/4/2010 MISC CITY OF DENVER VAM 689037 $0.21 ONRAD MISC TAX C 12/4/2010 VAM 689038 $467.14 BALANCE $0.00 Dou( EXPEr SE REPORT SUMMARY 12/02/10 12103/10 12/04110 STAY ID161 ROOM TA $217.07 $217.07 .00 34;74' MISCELLANEOUS $0.00 $0.00 $2,79 $2.79 FOOD BEVERAGE $30.00 $0.00 .00 $30.00 OTHER $0.00 $0.00 .21 $0.21 DAILY TOTAL $247.07 $217,07 .00 $467.14 e Hilluri Garden Inn You have earned approx mately 10950 HHonors p ints and approxima eiy 816 Miles with Delta Air Lines for this stay. T o check y ur earnings for this s tay or any other stay at any of m ore than 3,0 0 Hilt Ili Grand Vac.Ii uliu,u CIuL' ACCOUNT NO. DATE OF CI IARGE FOLIO N0./CHECK N'0, EiQLIE1Sl�OD 5UI "I'ES cAR 12 10��1�lo�la 66A 135599 A INITIAL ESTABLISHMENT NO. LOCATION rS1 ARI.I:a IAEEiN I AGRI-S P RANSMI I T)CARD I W1,13Fx PIRRAYMEN I PURCHASES SERVICFS HANEY, DOUGLAS U S A TAXES QW Off Cial Splonsvr "PIPS NIISC. CARD MEMBER'S SIGNATURE X TOTAL AMOUNT MERCH ANDi SC ANDIOR SERVICES PURCHASED ON THIS CARD SHALL NOT HE RLSOLD OR REi'URNED FORA CASH RI YPUND. PAY DUE UPON RECEIPT Haney, Douglas C From: nlcregandhousing @jspargo.com Sent: Wednesday, October 20, 2010 3:02 PM To: Haney, Douglas C Subject: Registration /Housing Confirmation and Receipt 102667 National League of Cities N LC COC 2010 Nov 30th -Dec 4th, 2010 The Colorado Convention Center Denver, CO Questions about your registration? Contact Us! Confirmation Number: 102667 Date of Registration: 1 012 012 01 0 Name: Doug Haney Title /Position: City Attorney Representing City: City of Carmel Address: One Civic Square City/State/Zip: Carmel, IN 46032 Country: USA Phone: 317 -571 -2482 Fax: 317- 571 -2484 Email: dhaneyCo)carmel.in.Aov Thank you for registering in advance. This confirmation includes your REGISTRATION INFORMATION ONLY. If you decide to make a housing reservation ti you will receive an additional confirmation that will include your housing information. This is your official confirmation. Please print this out and retain for your records. Registration Information REGISTRATION Full Conference $515.00 Payment Information Payment Type: CCD Payment Reference: Payment Amount: $515.00 Amoun 7Ou l e:$0,00 00 Amoun00 Balanc The credit card supplied f or payment has been charged for the applicable registration fees for the NLC Congress of Cities and Exposition. We will not accept alternate forms of payment or change of payment type once registration is submitted. Duplicate payments will be returned. Registration Change /Cancellation Information All requests for cancellation must be in writing, postmarked by, November 9, 2010. and are subject to a $75.00 processing fee. No partial refunds will be mad you decide not to attend particular functions. No registrations or cancellations will be accepted by telephone. No refunds for cancellations after November 9, Please be sure to save your changes before logging out of the system. If you do not receive an updated confirmation email or fax within 3 days, please conta NLC Registration and Housing Center at 888 319 -3864 or nlcregandhousingp, spargo.com Registration and Housing Center Information NLC Registration and Housing Center 11208 Waples Mill Road, Suite 112 Fairfax, VA 22030 1 INDIANA RETAIL TAX EXEMPT PAGE C"i _y Car CERTIFICATE NO. 003120155 d02 0 PURCHASE ORDER NUMBER FEDERAL EXCI AX EXEMPT 35- 600000 0972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION �l D 1 SHIP VENDOR TO CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION r'7 ika z n Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUN f PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS i HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. (f 7�� THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. J CLERK TREASURER I DOCUMENT CONTROL NO. 2 7 1 5 8 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO._ WARRANT NO. ALLOWED 20 IN THE SUM OF o ACCOUNT 0 APPROPRIATION FOR A 7 Board Members PO# or INVOICE NO. ACCT #MTLE AMOUNT 5FT-19 I 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_ C 20 ,/a Tif1e Cost distribution ledger classification if claim paid motor vehicle highway fund Hanel, Douglas C From: nlcregandhousing @jspargo.com Sent: Wednesday, October 20, 2010 3:02 PM To: Haney, Douglas C Subject: Registration /Housing Confirmation and Receipt 102667 National League of Cities NLC COC 2010 Nov 30th -Dec 4th, 2010 The Colorado Convention Center Denver, CO Questions about your registration? Contact Us! Confirmation Number: 102667 Date of Registration: 10120/2010 Name: Doug Haney Title /Position: City Attorney Representing City: City of Carmel Address: One Civic Square City]State /Zip: Carmel, IN 46032 Country: USA Phone: 317 -571 -2482 Fax: 317- 571 -2484 Email: dhaney(8carmel.in.gov Thank you for registering in advance. This confirmation includes your REGISTRATION INFORMATION ONLY. If you decide to make a housing reservation tf you will receive an additional confirmation that will include your housing information. This is your official confirmation. Please print this out and retain for your records. Registration Information REGISTRATION Full Conference $515.00 Payment Information Payment Type: CCD Payment Reference: Payment Amount: $515.00 Amount Due: $515.00 Amount Paid: $515.00 Balance Due: $0.00 The credit card supplied for payment has been charged for the applicable registration fees for the NLC Congress of Cities and Exposition. We will not accept alternate forms of payment or change of payment type once registration is submitted. Duplicate payments will be returned. Registration Change /Cancellation Information All requests for cancellation must be in writing, postmarked by, November 9, 2010. and are subject to a $75.00 processing fee. No partial refunds will be mad you decide not to attend particular functions. No registrations or cancellations will be accepted by telephone. No refunds for cancellations after November 9, Please be sure to save your changes before logging out of the system. If you do not receive an updated confirmation email or fax within 3 days, please conta NLC Registration and Housing Center at 888- 319 -3864 or nlcregandhousinq�a lspargo.com Registration and Housing Center Information NLC Registration and Housing Center 11208 Waples Mill Road, Suite 112 Fairfax, VA 22030 1 INDIANA RETAIL TAX EXEMPT PAGE Ci f C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION VENDOR SHIP I�'���'�`ti�( TO CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION X, 7 Am�'_ 4 rill m Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOU PROJECT I PROJECTACCOUNT AMOUNT J o0 PAYMENT .5,1.. o e) A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. P��` 7 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND =s" VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER- C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. �f THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ia_4f AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL No-27157 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE ,;VOUCHER NO. WARRANT NO. ALLOWED 2© IN THE SUM OF O ACCOUNT OFCAPP OPRlATION FOR yea Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 00- materials or services itemized thereon for which charge is made were ordered and received except ure _Title Cost distribution ledger classification if claim paid motor vehicle. ighway fund