197108 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $295.00
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
•c o INDIANAPOLIS IN 46205 CHECK NUMBER: 197108
CHECK DATE: 5/11/2011
DEP ARTMENT ACCOUNT P NUMBE I NVOICE NUMBER AMOUNT DESC
1081 4343000 295.00 TRAVEL FEES EXPENSE
PRPSCR[HED BY STATE BOARD OF ACCOUNTS
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MILEAGE CLA
YERN3MENIAL UNITt�
ON ACCOUNT OF APPROPRIATION NO. FOR
(O"CE, HOARD, DEPARTUVAT OR INST(TlIr30N)
FROM TO SPEEDOMETER AUTO TESL, EAGF
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POINT POINT START FJNISN NATURE OF BUSINESS TAA ELED
PER MILE
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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. Llrr
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
1
d
BY.
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
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All receipts should be attached in the same order as listed above,
No sates tax will be reimbursed. TOTAL:
Employee Name (print) now
Address j60
Check
payable to: City, St, Zip iAA A dlri 1 t1sr U 1pZZb
Signature. �r^� P� t/��l Approved by:
Date: Date: 4
Business Services Division, Revised 7 -7 -08 A P R q
FILE. Share (I\Administrative\FormslStaH Forms%Empioyee Exp Reimb Request io�
BY
NAT1C: NAt
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A 5 I A T l 0 N
NAA Invoice P
V a 2.16.2011 CK. NCB. !p
CIATE
From: National AfterSchool Association
8400 Westpark Drive, Suite 200
McLean, VA 22102
To: Serra Garske
Purchasing Administrator
Purchase
Carmel Clay Parks Recreation Description nr kr:srhnol 1�5�� W
P.O.# 2 P C&
Administrative Office G.L. /Q&1 99 d 351QO�L
1411 E. 116th Street Bud et
Carmel, IN 46032 Unetscr X�Gf"17G{ -�,f�S uGf
Purchaser Date
Reference PO 28198 Approval Date
Activity: 2011 NAA Convention Registration M (`7 7 7r Individual IP
a
Individual registrations, Join Now/ Renew 2 Day L�7. w' �y;
Q uantit y 9 r EE, 6 201 r
Price Per Individual: $410 BY. FHB 2 2
Total Due: $3690
For more information please contact NAA accounts receivable at amiller @naaweb.org.
A
April 16 -1$, 2011
p a
Gaylord Palms Resort Convention Center
Register Today!
Complete requested information and mail /email /fax registration with payment to:
National AfterSchool Association, c/o MMG
Name Y Badge Name
Organization CAM CL r r a o A lms J_ RawillotJ
Program /Agency (if applicable)
Address 1q II F. S(
City (or Military Base) CAMEL
State (or County of Province) Zip 03'—
Email4 l t- (A(pAd -S C*M Phone o Fax
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 s Y r Afterschooi Program
$335 $385 $aio Administrator /Director /Coordinator
Full Convention 5"�
Trainer /Consultant/Curriculum Specialist
Setlsun $290 $340 $365 College Instructor /Professor /Researcher
Member Rate
2 Days sunlMon Public School'Administrator /Principal /School
Board
Join Now or new $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 fist below.
Your Membership Renew
2 Days Sat /Sun
Youth Serving Organization
11-111 Su n/Mon Teacher /Frontline Staff
Non Member $455 $505 $530
Full Convention gyp` ,t Director /CEO
t fit:
Supporter /Researcher
Non- member Sat/Sun $41'5 $465 $490 Parks and Recreation
2 Days Sun on 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) Check to NAA
Make Checks Payable to:
TOTAL. Registration 300 �E Y q I0 National AfterSchool Association
If cto Meetings Management Group
Card Number Exp. 8400 Westpark Dr., 2k,d Floor
McLean, VA 22102
Card Name (printed) Phone: 703 -610 -0257 a Fax: 703- 610 -0203
Billing address registration @naaconvention.org
j
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4111/11 Reimb. Mileage 2128 4/11/11 112.20
4125111 Reimb. Natl Afterschool Assoc Conference 182.80
Total 295.00
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
Voucher No, Warrant No.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
295.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -2 Reimb. 4343000 112.20 1 hereby certify that the attached invoice(s), or
1081 -99 Reimb. 4343000 182.80 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
r
Signature
295.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund