165135 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 00353332 Page 1 of 1
ONE CIVIC SQUARE MICAH BECK
d CARMEL, INDIANA 46032 CIO CARMEL UTILITIES CHECK AMOUNT: $162.50
CIO CARMEL UTILITIES CHECK NUMBER: 165135
CHECK DATE: 10129/2008
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUN DESCRIPTION
65'. 5023990 162.50 OTHER EXPENSES
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: 1 DEPARTURE DATE: l G�2p j Q TIME:
DEPARTMENT: a i e S �C�L(1C'lC RETURN DATE: D a TIME: AM a
REASON FOR TRAVEL: �'o,yl`�vg� �S ®A �Qlry DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Date Transportation Gas/Tolis/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
3
6 S .no
S.
$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
$0.00
2, 0.00
Total
$0.001 $0.00 $0.001 $0.00 $0.001 $0.00 $0.00 $0.001 $0.00 0 1 $0.00
DIRECTOR'S STATEMENT: I hereby ffirm that all expenses listed conform to the City's travel olic and are within m department's appropriated bud et.
Y P Y P Y Y P 9
Director Signature: Date:
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City of Carmel Form ER06 Revision Date 10/24/2008 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 $60 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 $30 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 $30 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 $60 for out -of -state travel
EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES:
I 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.
I 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
I 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 a enditur )being ucted from the first paycheck issued more than 30 days after the date of my return.
1
Employee Signature: Date: /0 a y
City of Carmel Form ER06 Revision Date 10/24/2008 Page 2
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FINDIAY
THE UNIVERSITY OF FINDLAY
Certificate o c ie v ement
awarded by
N
SCHOOL OF ENVIRONMENTAL AND
EMERGENCY AGE ENT
to
E
U
Micah Beck
4
for Successful Completion of
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U
CONFINED SPACE ENTRY BASIC RESCUE WORKSHOP
(FOLLOWING 29 CFR 1910.146)
LO 8 HOURS OF TRAINING
N OCTOBER 22, 2008
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v
N EXECUTIVE DIRECTOR INSTRUCTOR
TH FINDIAY
E UNIVERSITY OF FINDLAY
Ce rtifi ca te o fAchi evement
N awarded by
SCHOO OF ENVIRONMENTAL ARID
EMERGENCY MAN
to
E
RJ
Micah Beek
c�
for Successful Completion of
n
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CONFINED SPACE ENTRANT /ATTENDANTI SUPERVISOR WORKSHOP
(FULFILLS THE REQUIREMENTS OF 29 CFR 1910.146)
8 HOURS OF TRAINING
N OCTOBER 21, 2008
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W
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a EXECUTIVE DIRECTOR INSTRUCTOR
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER
Form m No.No. 301 -S (Rev. 1995)
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
19 kl
Signature Title L
I hereby certify that the attached invoice(s), or bill(s), is (are) true and Corr ct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
19
cer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT ACCT.
CARMEL, INDIANA NO
Favor Of
11 t'cA h go C
l<
Total Amount of Voucher
Deductions
(o20O
70 YO-O( 5a
Amount of Warrant Sv
Month of 19
Acct.
VOUCHER RECORD Iva.
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1 -800- 382 -8702 325