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HomeMy WebLinkAbout196855 04/26/2011 CITY OF CARMEL, INDIANA VENDOR: 355319 Page 1 of 1 ONE CIVIC SQUARE MICHAEL KLITZING i CHECK AMOUNT: $2,250.64 CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE BROWNSBURG IN 46112 CHECK NUMBER: 196855 CHECK DATE: 4/26/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 2,250.64 TRAVEL FEES EXPENSE Carmel o Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense NAA Conference Hotel (Ben 4/18/2011 Ga for Palms 1081 4343000 Travel Fees Expenses 482.77 Johnson) NAA Conference Hotel (Tiffany 4/18/2011 Ga for Palms 1081 1 4343000 Travel Fees Expenses 574.07 Buckingham +1) NAA Conference Hotel (Jennifer 4/18/2011 Ga for Palms 1081 4343000 Travel Fees Expenses 574.07 Hammons +1) NAA Conference Hotel (Jennifer 4/18/2011 Ga for Palms 1081 4343000 Travel Fees Expenses 619.73 Brown +2) f N a l receipts should be attached in the same order as listed above. sles tax will be reimbursed. TOTAL: $2,250.64 Employee Name (print) Michael W.Klitzing o Address 1550 Redsunset Drive �pR q 2011 Check payable to: City, St, Zip Brownsburg, IN 46112 Signature: Approved by: Date: R) Date: Business Services Division, Revised 7 -7 -08 FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request GAYLORD PALMS RESORT CONVENTION CENTER NV .J GI Z� k BEN JOHNSON ROOM AA 8114 1411 EAST 116TH STREET ARRIVAL 4/15/11 DEPARTURE: 4/18/11 CARMEL IN 46032 NO_ IN PARTY 1 GROUP I_D_ A -NC411 PAGE 1 STATEMENT DATE 4/18/11 RESV NUfvjI3ER 405876443949 FOLIO NUMBER 406471547 DATE DESCRIPTION COMMENTS CHARGES PAYMENTS 4/15/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/15/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/15/11 ROOM CHARGE A_A 8114 189.00 TAX 24.57 4/15/11 OSCEOLA COUNTY ASSESSMENT 2.04 TAX .26 4/15/11 APPLIED DEPOSIT * 482.77 4/16/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/16/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/16/11 ROOM CHARGE AA 8114 189.00 TAX 24.57 4/16/11 OSCEOLA COUNTY ASSESSMENT 2.04 TAX .26 4/17/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/17/11 'NO PARKING.- CHARGE NO VEHICLE ON PROPERTY 4/17/11 ROOM .CHARGE AA 8114 t 189 00 TAX 24.57 4/17/11 OSCEOLA COUNTY ASSESSMENT I 2.04 TAX 26 TOTALS 698.46 698.48 Thank you for staying with us BALANCE DUE .02- �I1I© Express Check Out Thank you for staying at the Gaylord Palms" Resort Convention Center. Our records indicate that you will be departing today. Providing credit was established at check -in, we offer a quick and seamless method of checkout that does not require you to visit the Front Desk before your departure. Please take this Milli for your records. Any charges you incur after your departure will be charged to your credit card. If you have self parked with us, please retain your room key after checkout to exit the resort. In addition you may utilize our in -room video checkout or visit one of our kiosks located in our main lobby. If we can be of further assistance, please do not hesitate to contact Consider It Done at extension "88" or touch "0" fi-om your guest room phone. We hope you have enjoyed your stay and wish you a safe journey home. A `f aSLPCtn1+6:+ Apr V 16 18f 201.1 0 Gaylord Paims'.Resort.& Convention Center Register Today! Complete requested information and maillemaillfax registration with payment to: National AfterScflool Association, c/o MMG Name &iq Jpgtisol') Badge Nam Organization CAXM Ct.* 4 p Program /Agency (if applicable) Address �q f f S City (or Military Base) CRMEL aa'' State (or County of Province) Zip 01 Email 6n ASOA _LQ(WdAsj fk-S.&M Phone Fax 1 3-s>?- Step 3 Advanced On -Site Early Reg lleg Reg Sept 1 Dec 18, Apr 17- Your position (select one of the iollowing): Step S Step 2 Dee 31, 2010 Mar 20, 2011 2010 31, 2011 �,(Afterschool Program Member Rate rt $335 $385 $410 Full Convention r= 4 y° Administrator /Director /Coordinator TrainerlConsultantlCurriculum Specialist Me m ber Rate sat i un $290 $340 $365 College Instructor /Professor /Researcher 2 Days Sun/Mon Public School Administrator /Principal /School Board Join Now or $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschooi Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days SatiSun Youth Serving Organization sunlMon Teacher /Frontline Staff Non Member $455 $505 $530 Full Convention Director /CEO x Supporter /Researcher Non member saysun $415 $455 $490 Parks and Recreation 2 Days 3un/Mon Private, for profit Private not for P rofit w Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. ni c r t x C Card (Visa, MC, AMEX, Discove Y Check to NAA TOTAL Registration 3 l (I �E 3 r x `I fo pa� Make Checks Payable to: National AfterSchool Association clo Meetings Management Group Card Number Exp- 8400 Westpafk Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703- 610 -0257 r Fax: 703- 610.0203 registration @naaconvention.org Billing address GAYLORD PALMS'" RESORT CONVENTION CENTER A�z v4z, JENNIFER HAMMONS ROOM AA 8124 1847 WELCHWOOD CIR APT 289 ARRIVAL 4/15/11 DEPARTURE 4/18/11 INDIANAPOLIS lN 46260 NO. IN PARTY 2 GROUP I.D. A -NC411 PAGE 1 STAT DATE 4/18/11 RESV NUMBER 405876443937 FOLIO NUMBER 406471547197 DATE DESCRIPTION CONADaITS CHARGES PAYMENTS 4/15/11 FACILITY SERVICE FEE FACILITY SERVICE F=E 16.95 4/15/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/15/11 ROOM CHARGE AA 8124 229.00 TAX 29.77 4/15/11 OSCEOLA COUNTY ASSESSMENT 2.44 TAX .32 4/15/11 APPLIED DEPOSIT * 574.07 4/16/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/16/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/16/11 ROOM CHARGE AA 8124 229.00 TAX 29.77 4 4/16/11 OSCEOLA COUNTY ASSESSMENT 2.44 TAX .32 4/17/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/17/11 NO PARKING,- C-HARGE:'. NO VEHICLE ON PROPERTY 4/17/11 ROOM..CHARGE AA 8124n 229.00 TAX 4/17/11 OSCEOLA COUNTY ASSESSMENT TAX f r 32 TOTALS 835.44 =835 43''.' Thank you for staying with US BAT_Aw DUE 01 rr► amoom mw&my o mmkomm Mm?m 0 Ids r rrrr r r April 16-18,2011 y Gaylord Palms Resort 8 Convention Center Register Today! Complete requested information and mail /email /fax registration with payment to: t National A fterSch000ll Association, c/o MMG Name JErjtj I T (4mmoii S Badge Name JFAAPJ Organi zation Cat �L C.Lpt'`f AM J- �WTTIO Program /Agency (if applicable) Address Iq II E. IlVw City (or Military Base) C AMEL State (or County of Province) Zip Email j6,M MOAI &_CQratd(_`AtIWILT. GoM Phone W-Vn-SpLqo Fax 3 Step 3 Advanced On -Site Early Reg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 )(Afterschool Program Member Rate si�a 0 $335 $385 $41 Administrator /Director /Coordinator Full Convention Trainer /Consultant/Curriculum Specialist n. College Instructor /Professor /Researcher Member Rate Sat/Sun $290 $340 $$36 2 Days surdM Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Ot/Sun new 2 Days Youth Serving Organization S un/Mon Teacher /Frontline Staff Non Member $455 $505 $530 DlreCtOr /CEO Full Convention s Supporter /Researcher Non- member sausun $415 $465 $490 Parks and Recreation 2 Days Sun /Mon I I Private, for profit Private, not for profit Public School Please do not send me convention related materials from NAA authorized exhibltors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. C Card (Visa, MC, AMEX, Discove Check National to NAA TOTAL Registration 1 1 tT &F -W X QM.. J Make Checks Payable onal A1terSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 a Fax: 703 -610 -0203 registration@naaconvention.org Billing address GAYLORD PALMS" RESORT CONVENTION CENTER TIFFANY BUCKINGHAM ROOM AA 8118 5130 PRIMROSE AVE ARRIVAL 4/15/11 DEPARTURE 4/18/11 INDIANAPOLIS IN 46205 NO. IN PARTY 2 GROUP I.D_ A —NC411 PAGE 1 STATEMENT DATE 4/18/11 RESV NUMBER 405876443946 FOLIO NUMBER 406471547276 DATE DESCRIPTION COMMENTS CBARGES PAYMENTS 4/15 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/15/7.1 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/15/11 ROOM CHARGE AA 8118 229.00 TAX 29.77 4/7.5/11 OSCEOLA COUNTY ASSESSMENT 2.44 TAX .32 4/15/11 APPLIED DEPOSIT * 574.07 4/16/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/16/11 NO PARKING CHARGE NO VEHICLE ON PROPER'T'Y 4/16/11 ROOM CHARGE AA 8118 229.00 TAX 29.77 4/16/11 OSCEOLA COUNTY ASSESSMENT 2.44 TAX .32 4/17/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/1 NO CHARGE NO VEHICLE ON PROPERTY r 4/17/11 ROOM;CH_ARGE AA 8118 229.00 T �:M..; 29.77 4/17/11 OSCEOLA COUNTY TF x:'2'.44 TAX sy 3 2. TOTALS 835.4.4' -835 43 Thank you for ataying '.c,,,ith its BAr AN CE DUE .01 4 W4 G .Ntt10 Ml.t April 16-18,2011 a f e m NEW, Gaylord Palms Resort Convention Center Register Today! Complete requested information and mail /email /fax registration with payment to: Nationa AfterSchool Association, c/o MMG Name t Badge Name Organization �L Program /Agency (if applicable) Address IqII E. IIV S( City (or Military Base) State (or County of Province) r Zip Email' Qo 0 CAr(A2 C`ett1l&r�.i COM Phone W Fax 1171'511 m Step 3 Advanced On -Site Early Reg Reg Reg Sept 1 Dec 1 B Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate Afterschool Program y4a $335 Administrator /Director /Coordinator $385 $410 Full Convention Trainer /Consultant/Curriculum Specialist Mem ber Rate saysun $290 $340 $365 g Colle e Instructor/Professor /Researcher 2 Da s Sun /Mon y I I Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat /Sun Youth Serving Organization Sun /Mon Teacher /Frontline Staff Non- Member fi $455 $505 $530 Full Convention Director /CEO Supporter /Researcher Non- member Sat/Sun $415 $465 $490 Parks and Recreation 2 Days I Sun /Mon I I Private, for profit Private, not for profit Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. -t Credit Card (Visa, MC, AMEX, Discover) Check to NAA rQ qlo Make Checks Payable to: TOTAL Registration 310 e o 1 t National Afterschool Association c/o Meetings Management Group Card Number Exp. 6400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703 610.0203 Billing address registration @naaconvention.org GAYLORD PALMS" RESORT CONVENTION CENTER .7'G�/`GfGCr JENNIFER BROWN ROOM AA 8120 1411 EAST 116TH STREET ARRIVAL 4/15/11 DEPARTURE 4/18/11 CARMEL IN 46032 NO_ IN PARTY 3 GROUP I.D_ A —NC411 PAGE 1 STATEMENT DATE 4/18/11 RESV NUMBER 405876443910 FOLIO NUMBER 406471547142 DATE DESCRIPTION CO[volENTS CHARGES PAYMENTS 4/15/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/15/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/15/11 ROOM CHARGE AA 8120 249.00 TAX 32.37 4/15/11 OSCEOLA COUNTY ASSESSMENT 2.64 TAX .34 4/15/11 APPLIED DEPOSIT * 619.73 4/16/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/16/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/16/11 ROOM CHARGE AA 8120 249.00 TAX 32.37 4/16/11 OSCEOLA COUNTY ASSESSMENT 2.64 TAX .34 4/17/11 FACILITY SERVICE FEE FACILITY SERVICE FEE 16.95 4/17/11 NO PARKING CHARGE NO VEHICLE ON PROPERTY 4/17/11 ROOM _CHARGE AA 8120 249.00 TAX 32.37 4/17/11 OSCEOLA COUNTY ASSESSMENT 2.64 TAX 34 r r TOTALS 903.90 903.91 Thank you for staying with us BALAN DUE .01- April 16-18,2011 p Gaylord Palms Resort 8 Convention Center3 y Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG J Name EPJ4 owlm Badge Name _�3 ��►BJl �g2 Organization ;L 0 Program /Agency (if applicable) Address 1g ll F. 11614 S City (or Military Base) CARMgL State (or County of Province) t'" Zip Email 6TH eAfiy12 CIA CA Phone 3i1 59 40 Fax 3 M Step 3 Advanced On -Site Early Reg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate 'VY s Afterschool Pro 1 $335 $385 $410 Full Convention Administrator /Director /Coordinator Trainer /Consultant/Curriculum Specialist Member Rate S at/Sun $290 $340 $365 g Colle a Instructor /Professor /Researcher 2 Days Sun/Mon Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days sa"sun Youth Serving Organization Sun/Mon Teacher /Frontline Staff Non- Member t x $455 $505 $530 Full Convention Director /CEO Supporter /Researcher Non member saysun $415 $465 $490 Parks and Recreation 2 Days SunlMon Private, for profit Private, not for profit Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Credit Card (Visa, MC, AMEX, Discover) YCheck to NAA TOTAL Registration (i A rr e m f X qlo- Make Checks Payable to: National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, 22102 Card Name (printed) Phone: 703.610 0257 Fax: 703-610-0203 Billing address registration @naaconvenlion.org ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be property 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. 355319 Klitzing, Michael Terms 1550 Redsunset Dr Date Due Brownsburg, IN 46112 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4118111 Reimb Lodging for NAA Conference 2,250.64 Total 2,250.64 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 i Voucher No. Warrant No, 355319 Klitzing, Michael Allowed 20 1550 Redsunset Dr Brownsburg, IN 46112 In Sum of 2,250.64 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -99 Reimb 4343000 2,250.64 1 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 21 -Apr 2011 Signature 2,250.64 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund