196511 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 354306 Page 1 of 1
0 ONE CIVIC SQUARE MICHAEL PITMAN CHECK AMOUNT: $260.00
CARMEL, INDIANA 46032
CHECK NUMBER: 196511
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 260.00 TRAINING SEMINARS
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Michael Pitman DEPARTURE DATE: 28- Mar -11 TIME: 8:00 Aft, PM
DEPARTMENT: Carmel Police Department /Investigations RETURN DATE: 31- Mar -11 TIME: 8:00 AM PM
REASON FOR TRAVEL: Child Abuse Training DESTINATION CITY: Huntsville, AL
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN X TRAVEL PER DIEM $65.00
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
3/28/11 $65.00 $65.00
3/29/11 $65.00 $65.00
3/30/11 1 1 $65.00 $65.00
3/31/11 $65.00 $65.00
$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 im
0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00 •1
DIRECTOR'S STATEMENT: I here rm 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 3/21/2011 Page 1
Lam,.
Vic; The National Children's
i `�Bl Advocacy Centel
27 th National Symposium on Child Abuse, Huntsville, AI_ March 28 -31, 2011
First and Last Name:
Agency:
�A e 1 colI ce.
Address:
Cit
State:
Zip: 1,co 3
Work Phone: S21
Fax !Number: 3 7 7�
Email Address:
Discipline: (Please check the one that most closely describes vour current positio V
To mark an "X" in the box below, double click on the box, under, "Default Value," select, "Checked" and then click, "OK"
Medical Prevention Victim Advocate Child Protective Services
Legal Administration Mental Heal IIVTreat men l
Kaw F Child Forensic Interviewer
Enforcement Other (Please Specify
Conference Registration Rates Per Person: Pre Conference Sessions:
When paying by Credit Card or Check (Held on Monday, March 28, 2011, 8:30 a.m. 4:00 p.m.)
5449 on or before Jamrary 22, 201 1 $99 —NICHD Interview Protocol 101
S499 after January 22, 2011 $99 Using What Sex Offenders Tell Us to Improve Child Safety
When Payi by Military Order or P urc h ase dat
Order: V
KY 4 regardless of registration date ly-"} TOTA AMOUNT ENCLOSED OR TO BE CHARGED
Method of Payment
Check or Money Order For S Enclosed Payable to NCAC (Must be in U.S. Dollars Drawn on U.S. Bank)
29 Order on Or "s Form enclosed.
Military Voucher Lncloscd.
❑crcditCard: VISA AmericanFxpress
C ird I loldcr's Nam,; (Please Print),
Card Fxpirrtion date
Signature
Please Solid "This Form and Payment to:
fT Mail: A'atioual Children's Advocacy Center Fax: 256- 327 -3856 (with credit card information)
Attn: Ann Blalock
310 Pratt Avenue Register On- l -inc: iv��FV.nationalcac_ora
Huntsville, Alabama 35801 (Using Credit Card)
Federal I.D. 463 -0891512
CANCFI.L.ATION POLICY
1Vrinen cancellations r ceivtd by PcbruarN 2S, 201 1 1xill he rctimdcd. Icss a S75 admiei.sualk C charg0. NO Rl"FUNDS 101 he made alter
hehruary 28, 2(11 I. (Registration fee is'I ranslcrak�le at n� additional charge.) ALL Replacements unciAnr CEtanges ��•ill be handled On Site}
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mike Pitman
IN SUM OF
$260.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
210 570.00 $260.00 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
t 0 c��
Wednesday, March 30, 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))
04/01/11 reimburse Det. Pitman for meals $260.00
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