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Home My WebLink About197856 05/26/2011 �N« CITY OF CARMEL, INDIANA VENDOR: 318025 Page 1 of 1 ONE CIVIC SQUARE DAVID R VANDERBECK CARMEL, INDIANA 46032 CHECK NUMBER: 197856 CHECK DATE: 5!26/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4343003 1,583.55 TRAVEL LODGING OF C Agj�i c b, CITY OF CARMEL Expense Report (required for all travel expenses) �`NDIANp EMPLOYEE NAME: David Vanderbeck DEPARTURE DATE: 5/11/2011 TIME: 400 AM PM DEPARTMENT: Carmel PD RETURN DATE: 5/16/2011 TIME: 1700 AM/PM REASON FOR TRAVEL: National Law Enforcement Memoria DESTINATION CITY: Washington D.C. EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN JC, TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Parkin Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem 5/11/11 $65.00 $65.00 5/12/11 $65.00 $65:00 5/13/11 $65.00 $65.00 5/14/11 $65.00 $65.00 5/15/11 $65.00 $65.00 5/16/11 $1,193.55 $65.00 $1,258.55 $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 Totall $0.00 $0.00 $0.00 $0.00 $1,193.55 $0.00 $0.00 $0.00 $0.00 $390.00 DIRECTOR'S STATEMENT: I by affir that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: 3 1 City of Carmel Form ER06 Revision Date 5/17/2011 Page 1 For advance payments, claim form must be submitted ten (10) business days in advance of travel. Claim will not be processed without the following documentation: 1) Conference or course registration form, if applicable 2) Travel itinerary or car rental agreement, if applicable 3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt) Prorated meal allowance: For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in -state travel and $65 for out -of -state travel For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in -state travel and $32.50 for out -of -state travel For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in -state travel and $32.50 for out -of -state travel For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in -state travel and $65 for out -of -state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: hereby acknowledge receipt of such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen. understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to: 1) Submit original itemized receipts to the office of the Clerk- Treasurer documenting all meal expenditures; and 2) Return all unused funds to the office of the Clerk- Treasurer further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: City of Carmel Form FRO6 Revision Date 5/17/2011 Page 2 r r 1-10MEWOOD 4850 Leesburg Pike Alexandria, VA 22302 SUTM Phone (703) 671 -6500 Fax (703) 671 -9322 Reservations Name Address Hilton homewoodsuites.com or 1 -800- CALL -HOME qD VANDERBECK, DAVID Room 310/TGSN 703 SENNETT RD Arrival Date 5/11/2011 3:03:OOPM Departure Date 5/16/2011 CARLMEL, IL 46032 US Adult /Child 110 Room Rate 219.00 RATE PLAN LV3 HH# 905655612 BLUE AL: BONUS AL: CAR: CONFIRMATION NUMBER: 86259191 5/16/2011 PAGE 1 DATE REFERENCE DESCRIPTION AMOUNT 5/11/2011 1577895 GUEST ROOM $219.00 5/11/2011 1577895 STATE TAX $10.95 5/11/2011 1577895 COUNTY TAX $8.76 5!12/2011 1578107 GUEST ROOM $219.00 5/12/2011 1578107 STATE TAX $10.95 5/12/2011 1578107 COUNTY TAX $8.76 5/13/2011 1578323 GUEST ROOM $219.00 5/13/2011 1578323 STATE TAX $10.95 5/13/2011 1578323 COUNTY TAX $8.76 5/14/2011 1578496 GUEST ROOM $219.00 5114/2011 1578496 STATE TAX $10.95 5114/2011 1578496 COUNTY TAX $8.76 5/15/2011 1578672 GUEST ROOM $219.00 5/15/2011 1578672 STATE TAX $10.95 5/15/2011 1578672 COUNTY TAX $8.76 WILL BE SETTLED TO dIRIbb $1,193.55 EFFECTIVE BALANCE OF $0.00 EXPENSE REPORT SUMMARY 1 00:00:001 12:00:OOAM 011 12:00:00AM11 12:00:00AM ROOM TAX $238.71 $238.71 $236.71 $238.71 DAILY T TAL $238.71 $238.71 $238.71 $238.71 EXPRESS CHECK-OUT DATE DP CHARGE FOLfb NO,lCFIECK NO. Good Morning We hope you enjoyed your stay. With Express Check -Out AUTHORIZATION 173186 &TIAL there is no need to stop at the Front Desk to check out. y Please review this statement. It is a record of your charges as of late last evening. PURCHASES &.SERVICES For any charges after your account was prepared, you may: pay at the time of purchase. 'FAXF_S charge purchases to your account, then stop by the Front Desk for an updated statement. or request an updated statement be mailed to you within two business days. TIPS &,MISC. Simply call the Front Desk from your room and tell us when you are ready to depart. Your account will be automatically checked out and you may use this ToTn1, AntouNT statement as your receipt. Feel free to leave your key(s) in the room. 0.00 Please call the front Desk if you wish to extend your stay or if you have any questions about your account. PAYMENT DUE UPON RECEIPT 1.5% PER NtONTn INTEREST CHARGE WILL BE APPLIED TO ALL PAST DUE INVOICES. HOMEWOOD 4850 Leesburg Pike Alexandria, VA 22302 ST n Phone (703) 671 -6500 Fax (703) 671 -9322 Vi 1 i:s Reservations Name Address Hi l ton homewoodsuites.com or 1- 800 -CALL -HOME q) VANDERBECK, DAVID Room 310/TGSN 703 BENNETT RD Arrival Date 5/11/2011 3:03:OOPM Departure Date 5/16/2011 CARLMEL, IL 46032 US Adult/Child 1/0 Room Rate 219.00 RATE PLAN LV3 HH# 905655612 BLUE AL: BONUS AL: CAR: CONFIRMATION NUMBER: 86259191 5/16/2011 PAGE 2 DATE REFERENCE DESCRIPTION AMOUNT- 1 00:00:00 STAY TOTAL ROOM TAX $238.71 $1,193.55 DAILY TC TAL $238.71 $1,193.55 You have ea ed approximately 10950 HHonors points for this stay. To check our earnings for this stay or any o er stay at any of more than 3,000 Hilton Family hotels worldwide visit HiltonHHonors.co EXPRESS CHECK -OUT DATE OF CHARGE FOLIO NO. /CHECK N0. 7V Good Morning We hope you enjoyed your stay. With Express Check -Out AUTHORIZATION 173186 }b ITIAL JJL there is no need to stop at the Front Desk to check out. Please review this statement. It is a record of your charges as of late last evening. PURCHASES SERVICES For any charges after your account was prepared, you may. pay at the time of purchase. TAXES charge purchases to your account, then stop by the Front Desk for an 0 updated statement. or request an updated statement be mailed to you within two business days. TIPS MISC. Simply call the Front Desk from your room and tell us when you are ready to depart. Your account will be automatically checked out and you may use this TOTAL AMOUNT statement as your receipt. Feel free to leave your key(s) in the room. 0.00 Please call the Front Desk if you wish to extend your stay or if you have any questions about your account. PAYMENT DUE UPON RECEIPT 1.5% PER MONTH INTEREST CHARGE WILL BE APPLIED To ALL PAST DUE INVOICES. VOUCHER NO. WARRANT NO. David R. Vanderbeck ALLOWED 20 IN SUM OF $1,583.55 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members Prior Year I hereby certify that the attached invoice(s), or 1 110 43- 430.03 bill(s) is (are) true and correct and that the 1110 43- 430.03 $1,583.55 materials or services itemized thereon for which charge is made were ordered and received except Monday, May 23, 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 20 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)) attending Police Memorial Week 05/23/11 reimburse Officer Vanderbeck for meals and lodging while $1,583.55 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