HomeMy WebLinkAbout197265 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 357976 Page 1 of 1
0 ONE CIVIC SQUARE BENJAMIN JOHNSON CHECK AMOUNT: $230.40
CARMEL, INDIANA 46032 11182 HARRISTON DRIVE
roN `o FISHERS IN 46037 CHECK NUMBER: 197265
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
1081 4343000 REIMB 230.40 TRAVEL FEES EXPENSE
Carmel Clay
Parks &Recreate ®n Ivy "A- er5cko_ 1
Employee Expense Reimbursement Request 'A-�oc
C n( rO/'1CQ
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
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Al ��2 SfUTTLE lq( YMWO V#JO-00
VLAA gi q�gy000 11 �43,S6 y D 10JAJM_
8 bOMQ SOUM P Co, f 9� g3000
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
��SQA) 23D, 0
Employee Name (print)
Check Address _L 1 2 1 AY 01?
payable to: City, St, Zip f i �S /A qW 11,9
f
Signature: Approved by:
Date: L t44 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\Forms\staff Forms \Employee Exp Reimb Request
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N A T I 0 N A L
A S S 0 C I A T i 0
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CBS
NAA Invoice
2.16.2011
From: National AfterSchool Association
8400 Westpark Drive, Suite 200
McLean, VA 22102
To: Serra Garske
Purchasing Administrator
Purchase
Carmel Clay Parks Recreation Description fi4ffluxb o/
P.O. oZ S/ 9R P t F
Administrative Office G.L. A0&—J 'Y 35700 7f
1411 E. 1 16th Street Budget 1
Line
M s X7tiY/7GL� �llS�'uGf
Carmel, 1N 46032
Purchaser Date
Reference PO 28198 Approval Date
Activity: 2011 NAA Convention Registration
Individual registrations, Join Now/ Renew 2 Day
Quantity: 9
F EE,� 6 201
Price Per Individual: $410 FEB 2 2
Total Due: $3690
For more information please contact NAA accounts receivable at amiller @naaweb.org.
y G H A't f -0 H F't
April 16-18,2011
Gaylord Palms Resort Convention Center
Regisler Today!
Complete requested information and mail /emall /fax registration with payment to:
National AfterSchool Association, c/o MMG
Name &fq JoHtjS®r) Badge Name serp'j
Organization CAXM CXM ?A
Program /Agency (if applicable)
Address lq f l E 116
City (or Military Base) GAME— ,l
State ([[[or County of Province) Zip �f a--
Emai1 so n C�trmJ &f ks cem Phone M SP-0 Fax 3s�'S73 -S�-S
Step 3 Advanced On -Site
Eafly Reg Reg Reg
Sept 1 Dec 18 Apr r7- Your position (select one of the following):
Step 1 Step 2 Dec 31, 2010 Mar 20, 2011
2010 31, 2011
Member Rate asfr $335 $385 $410 Afterschool Program
t Administrator /Director /Coordinator
Full Convention 4
Trainer /Consultant/Curriculum Specialist
College Instructor /Professor /Researcher
Member Rate Sat/Sun $290 $340
2 Days Sun /Mon I Public School Administrator /Principal/School
Board
Join Now or Renew $395 $445 $470 Government E=mployee
Your Membership Join
Full Convention Renew
For Afterschool Program Staff, please indicate
Join Now or Renew Join $360 $435 the type of program from the list below.
Your Membership Renew
2 Days SaUSun
`Youth Serving Organization
Su Teacher /Frontline Staff
Non Member $455 $505 $530
Full Convention Director /CEO
f Supporter /Researcher
5 t ci!
Non Sat/ Bun $415 $465 $490 Parks and Recreation
member
2 Days SunlMon I l; 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, A M E r XX, Discover) Check to NAA
TOTAL Registration 6
(I E1`i.'3G.� f #qlo pa) Make Checks Payable to:
National AfterSchool Association
c/o Meetings Management Group
Card Number Exp. 8400 Westpark Dr., 2 nd Floor
McLean, VA 22102
Card Name (printed) Phone: 703- 610 -0257 e Fax: 703- 610 -0203
registration@naaconvention.org
Billing address
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
357976 Johnson, Ben Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/21/11 Reimb Natl Afterschool Assoc conf 230.40
Total 230.40
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.
357976 Johnson, Ben Allowed 20
In Sum of
230.40
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 Reimb 4343000 230.40 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
4 -May 2011
Signature
230.40 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund