HomeMy WebLinkAbout196340 04/13/2011 �I
CITY OF CARMEL, INDIANA VENDOR: 248970 Page 1 of 1
0 f ONE CIVIC SQUARE ANN GALLAGHER
CARMEL, INDIANA 46032 171 PARKVIEW COURT CHECK AMOUNT: $263.50
CARMEL IN 46032 CHECK NUMBER: 196340
CHECK DATE: 411312011
DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
210 4357000 263.50 TRAINING SEMINARS
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Ann Gallagher DEPARTURE DATE: 3/26/2011 TIME: 5:45AM AM PM
DEPARTMENT: Police Department RETURN DATE: 3/30/2011 TIME 12:57AM AM/PM
REASON FOR TRAVEL: Training DESTINATION CITY: Phoenix, AZ
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
3126/11 $1.75 $65.00 $66.75
3/27/11 $65.00 $65.00
3128/11 1 1 $65.00 $65.00
3/29/11 $1.75 $65.00 $66.75
$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
$0.00
0.00
Total $0.001 $0.001 $3.501 $0.00 $0.00 $0.00 $0.00 $0.001 $0.001 $260.00 $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:
City of Carmel Form ER06 Revision Date 3/31/2011 Page 1
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First name:
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Preferred first name for bad e:
Organization: 2 0R2 U fT ESJQ 1/ L W
Address: Ci c1; c lCa�e
C�Ir/ X `1003 P6HOr, N19 AR Z0NA
City: State� lip:
Telephone: (3 .-4 Cell:
Flur,+ l' ,;allrKr'!6F%ruNC�7 rn 1XCc)ror::r>ai �!I!)!S f
E -mail: )7 e,- C.A'Tme �r�olf .�:,.�,�'3 i`;.-
Registration i will be sent to the email address above.
List any additional email addresses where your confirmation should be sent:
Send this form with your payment or purchase
Check if you do not want your contact information printed In conference materials.' order to:
Special Requirements: I 3y iUai1:
ndicate the day(s) you will be allending conference �L Sunday ❑I londa y y Lifesavers Conference, In(.
Conference Registration
Will you be slaying at one of (he conference hotels? CJ Yes No P.O. Box 30045
If not, where will you be staying? Alexandria, Virginia 22310
is this your first Lifesavers Conference? Yes F7� O r
What field do you work in? CommunityPrograms
Consullanl Researcher (703)9 Do not mail form after faxing.
Insurance Industry EMS /Fire Local Government Lifesavers Fed. ID 4: 52- 1648356
Child Passenger Safety Public Health /Medical Slale(Federal Govt.
Child Restraint Manufacturer E- Enforcement ❑Auto Industry
N T& If you do not receive a confirmation via
r 7 email or L.S. mail from us within 114 days, please
Advocacy /Consumer Group judge /Prosecutor Student
contact us at (703) 922-7944 or email us at
registrar@PTFAssodaWs.com
(Check one)
Your registration fee includes an opening reception, a continental breakfast, two lunches,
refresh nt breaks, exhibits, workshops, and program materials. uCp u• Y ra I;s �J Grl i
i Early -Bird Special until January 14, 2011 $300
I[__� Regular Regislralion January 15 to February z,, 2011 5350
Late /On Sile Registration after February 25, 2011 £1;5o f
Lifesavers does not accept cancellations by phone.
Cancellations must be mailed to Lifesavers Conference,
ModeralorfSpeaker S3oo
or ernalled to registrarc�i ptfassociales.com. You wilt
Moderator /Speaker (one day, day of attending presentation only) No Charge receive a confirmation ofyour cancellation. Requests
Please Indicate day received by March 14, 201! will be refunded less a S25
Student (artach copy ofyourstudent D.) $25 administration fee. Refunds wiil be issued after the
conference. Requests made after March 14, 2011 or
Note: Additional exhibit personrrel please use f6e exhibit regisGationlorm. Total AnlOUnl Due S '�n0 ShD4 +15 "are not eligible for a refund.
Check one Visa MasterCard Check t v-4-4-1 h ase Order'
Paying by credit card orpurchase order. Register ontine at vvww.lifesaversconference.org Registration must be mailed by March 16, 2011
Card Number. Expires, 1 tWz Codc:
After that dale wait and register on -site,
rAeC1+'71n0.•,sd lUisil:otle lourtu on r✓.e trilA olyour[I••Cil rar0
Registration fees must be paid by check in U.S,
i agree to pay the above total amount according to card issuer agreement. dollars (payable to Lifesavers Conference. Inc.),
credit card (Visa or MasterCard) or attached
Signature: purchase order. We do not accept
American &press.
Prinl name as it appears on card: j
Registrations received without payment or
Purrha�rder must be attached.
Indicate 6111 -to address if different from ove regislralio dress. /1 purchase order number wiII not be processed.
Alin: t� i �/I(� 2(SC)fl Organization:
A�/Y1P�yl /(p
Address: cri/rL u G 4 e co/Staie/zip:
'Contact information will only be used for meeting purposes. The registration list is offered for sale to exhibitors only.
THE TRAVEL AGENT tel 317846.9619 800.347.2512
�r�fi«rfe�aura�ia fax 317848.3998
email info @thetravelagent.travel
Established 1979.
web www.thetravelagenttravel VIR'l,U0soME\413ER.
11562 Westfield Boulevard Carmel, Indiana 46032 P•< „s .r,• .,oFra ,F.
SALES PERSON: DT2 ITINERARY /INVOICE NO. 68333 DATE: JAN 10 2011
ACCOUNT P16DME PAGE: 01
OR:
GALLAGHER /ANN
0: CITY OF CARMEL CITY OF CARMEL POLICE DEPT
ONE CIVIC SQUARE 3RD FLOOR ATTN:LUANN THURSTON
CARMEL IN 46032 THREE CIVIC SQUARE
CARMEL IN 46032
6 MAR 11 SATURDAY MILES- 1489 ELAPSED TIME- 4:07
IR LV INDIANAPOLIS 545A US AIRWAYS FLT: 180 COACH CLASS CONFIRMED
AR PHOENIX 652A NONSTOP FOOD TO PURCHASE
RESERVED SEATS 18A
AIRLINE CONFIRMATION:US A3BP3M
9 MAR 11 TUESDAY MILES- 1489 ELAPSED TIME- 3:17
IR LV PHOENIX 640P US AIRWAYS FLT: 500 COACH CLASS CONFIRMED
AR INDIANAPOLIS 1257A NONSTOP FOOD TO PURCHASE
RESERVED SEATS 16C OPERATED BY--30 MAR
AIRLINE CONFIRMATION:US A3BP3M
THIS IS AN ELECTRONIC TICKET. PLEASE PRESENT PHOTO
ID AT CHECK IN WITH AIRLINE CONF. TICKET IS COMPLETELY
NONREFUNDABLE IF UNUSED. MAY CHANGE ONLY PRIOR TO ORIGINAL
TRAVEL DATE. FEES WILL APPLY.
US AIRWAYS CONF A3BP3M
"YOU MUST VERIFY ALL INFORMATION IS CORRECT. ONCE ISSUED
FEES AND PENALTIES EXIST FOR REISSUES REFUNDS CHANGES. AFTER
HOURS EMERGENCIES ON EXISTING RESERVATIONS CALL 1 877 645 6373
CODE A09- $15.00 PER CALL. A CANCELLATION FEE OF 15PCT ON
TOTAL COST OF ALL BOOKINGS WILL APPLY. REFER TO WWW.TTA.TRAVEL
FOR TERMS AND CONDITIONS- AIRLINE LUGGAGE POLICES AND
OTHER SERVICES OFFERED.
THANK YOU. DEBBIE TUNSTILL 317 730 6210 OR OFFICE'AT 317 846 9619
TICKET NUMBER /S:
GALLAGHER /ANN 7860461191 CARD 339.40
ELECTRONIC
AS YOURTRAVEL ADVISOR, WE RECOMMENDYOU ALWAYS PURCHASE INSURANCE FOR ALL TRAVEL COMPONENTS. TRAVELEX INSURANCE SERVICES IS OUR PREFERRED PROVIDER..
FOR TERMS AND CONDITIONS,REFERTO: WWW.TTA.TRAVEL/TERMS
THE TRAVEL AGENT tel 317846.9619 800.347.2512
/���rixQar¢�zGfir�i <cGa�r�s�a fax 317848.3998
v Fstahlished 1979. email info @thetravei age nt.t rave I
web www.thetravelagent.travei VI R'I'UOSOME', BEK.
11562 Westfield Boulevard I Carmel, Indiana 46032
ALES PERSON: DT2 ITINERARY /INVOICE NO. 68333 DATE: JAN 10 2011
ACCOUNT P16DME PAGE: 02
)R:
GALLAGHER /ANN
CITY OF CARREL CITY OF CARREL— POLICE DEPT
ONE CIVIC SQUARE 3RD FLOOR ATTN:LUANN THURSTON
CARMEL IN 46032 THREE CIVIC SQUARE
CARREL IN 46032
AIR TRANSPORTATION 295.81 TAX 43.59 TTL 339.40
PROCESSING FEE 35.00
SUB TOTAL 374.40
CREDIT CARD PAYMENT 374.40
TOTAL AMOUNT 0.00
AS YOUR TRAVEL ADVISOR, WE RECOMMEND YOU ALWAYS PURCHASE INSURANCE FOR ALL TRAVEL COMPONENTS. TRAVELEX INSURANCES ERVIC IS ISO UR PREFERRED PROVIDER..
FOR TERMS AND CONDITIONS, REFER TO: WWW.TTA.TRAVEL/TERMS
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ann Gallagher
IN SUM OF
171 Parkview Court
Carmel, IN 46032
$263.50
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
210 570.00 $263.50 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
Thursday, March 31, 2011
Chief of Police
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))
03/31/11 reimburse Ann Gallagher for meals train for training $263.50
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