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HomeMy WebLinkAbout198117 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1 ONE CIVIC SQUARE DOUGLAS HANEY CARMEL, INDIANA 46032 CIO DEPT OF LAW CHECK AMOUNT: $1,210.23 C/O DEPT OF LAW CHECK. NUMBER: 198117 CHECK DATE: 6/612011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343004 1,210.23 TRAVEL PER DIEMS PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1886) MILEAGE CLAI i TO IG VERNMENTAL UNIT) y30 n I n o ON ACCOUNT OF APPROPRIATION NO. `/3,V0 FOR StA2 G� FVQ T (OFFIC BOARD, DEPARTMENT OR INSTITUTION) DATE FROM TO SPEEDOMETER AUTO MILEAGE C2041 READING NATURE OF BUSINESS MILES Q c POINT POINT START FINISH TRAVELED PER MILE o g 1a Sac r a s I T e.` S Gr S G3 0 AUTO LICENSE NO. TOTALS Sos /1 SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. U 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 2nd that no part of the same has been paid. Date a6 O�o Claim No. Warrant No. I have examined the within claim and hereby IN FAVOR OF certify as follows: k" That it is in proper form. C That it is duly authenticated as required by law That it is based upon statutory authority. aCJ"'°' �/so That it is apparently correct incorrect ����ss Disbursing Officer On Account of Appropriation No. Y3c�!V for �l0 •01 Pi rn 0 o Allowed 19_ M w 0 w a y in the sum of o ID M 117 M M m P, tp n a. tr o n K m (Board or Commission) n 0. M ZT a FILED rA to w a m ta M m a'n (Official Title) 0 W fD m C tr' N 0._E. BOYCE CO., INC. MUNCIE, IN 0113r C1 a, CITY OF CARMEL Expense Report (required for all travel expenses) /NDIANp EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 05/11/11 After 1:00 p.m. DEPARTMENT: Law Department RETURN DATE: 05/13/11 TIME: fter 1:00 p.m. REASON FOR TRAVEL: Ogletree Deakins Seminar DESTINATION CITY: Chicago, Illinois EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other 9 Breakfast Lunch Dinner Snacks Per Diem May 11 13, 2011 $92.00 $713.18 $180.00 $985.18 $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 $0.00 $0.00 0.00 Total $0.00 $0.00 $0.00 $92.00 $713.18 $0.00 $0.00 $0.00 0 .00 $0.00 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. ignature: Date: arm ER06 Revision Date 5/17/2011 Page 1 201 N. State Street Chicago, IL 60601 he i Phone (312) 467 -0200 Fax (312) 467 -0202 A DOUBLETREE HOTEL For reservations across the nation Name Address www.doubletree.com or 1- 800 222 -TREE HANEY, DOUGLAS Room 2107/NK1S 13828 SMOKEY RIDGE DR Arrival Date 5/11/2011 9:34:OOPM Departure Date 5/13/2011 CARMEL, IN 460339101 Adult/Child 1/0 US Room Rate 309.00 RATE PLAN S -DJ1 G lic HH# AL BONUS AL Confirmation Number: 88250328 The Hilton Family. 5/13/2011 PAGE 1 DATE DESCRIPTION ID REF. NO CHARGES CREDITS BALANCE `V- 5/11/2011 'VALET PARKING LINTR 719088 $46.00 Hilton 5/11/2011 GUEST ROOM WH1 719322 $309.00 5/11/2011 ROOM TAXES WH1 719322 $47.59 5/12/2011 'VALET PARKING LINTR 720108 $46.00 oONRAD" RL.o.TE 5/12/2011 GUEST ROOM MR1 720292 $309.00 5/12/2011 ROOM TAXES MR1 720292 $47.59 WILL BE SETTLED TO MC `0 311 $805.18 DOVE LET RE E' Hilton HHonors(R) stays are posted within 72 ho rs of checkout. To qheck A a D T E B your earnings for this o any other stay at more t an 3,000 Hilton Fa ily hotels worldwide, plea e visit HiltonHI-fonors.corn. Thank you for choosinc I Doubletree! Gome back soon to enjoy'our w rm chocolate chip cookies and relaxed h Dspitality. F or your next trip visi us at doub /etree.com for our best available rates! e Hilton Gardenlnta Hilton Grand Vacations HOME© ACCOUNT NO. DATE OF CHARGE FOLIO N0. /CHECK NO. 118008 A ®r HOMEWOOD SURFS CARD MEMBER NAME AUTHORIZATION INITIAL ESTABLISHMENT NO. LOCATION ESTABLISH.ENTAGREFS TOTRANSMIT TO CARD HOLDER FOR PAYMENT PURCHASES SERVICES TAXES COLLECTION' TIPS MISC. CARD MEMBER'S SIGNATURE X TOTAL AMOUNT MERCHANDISE ANDIOR SERVICES PURCHASED ON THIS CARD SHALL NOT BE RESOLD OR RETURNED FOR A CASH REFUND. PAYMENT DUE UPON RECEIPT Zogletpee Dial INVOICE Date: 03/21/2011 Company: City of Carmel, Indiana Address: One Civic Square City: Carmel State: IN Zip: 46032 E -mail Address: dhaney @carmel.in.gov Program Registration For: Douglas Haney City Attorney Program Name: CHICAGO, IL 2011 National Workplace Strategies Seminar Program Date: 05/12/2011 Program Fee /Total Amount Due: $895.00 Remittance Address: Ogletree Deakins P.O. Box 89 Columbia, SC 29202 PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR PAYMENT. 1 ....lo +roorlc.L:.,o n..r., /v.or+ +n /nnmm .F 7�ncaant inn= TnvniraR�rarrictratinnir -IF 'Z/7� /7(11 1 o LF r��oa�00 c�aoc�QOOo �000��0�0� paaa UVt1G1U M4 go M U Nang o .00 c n pew:° 1 1, �'h� ��i �r l�rl sn=" 'R~ rol k BAP b r /�lf to sacs a i 1 s RU� 9 719!lE�ll �l.'� C ity Carmel INDIANA RETAIL TAX EXEMPT PAGE CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT ,(��O I lq W 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. EVENDOR NO. DESCRIPTION VENDOR k"/n� SHIP TO P� SHIP 0 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION rp 1 A��� f rte.. -�✓C.' yLe.. �i 4 r �G�' v a Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT �/,3 pI> PAYMENT 95 A/P VOUCHER CANNOT BE APPROVED O I MADE A PART OF THE VOUCHER AND EVERY VOICE AND NUMBER HAS THE PROPER SWORN AFFIDAVIT T ATTAC ED VOUCHER SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE il� l �t A A j:✓1 flr Q l A AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �j CLERK- TREASURER C✓ DOCUMENT CONTROL NO. �j 6 7 4 3 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF$ A r--111 1 OX CCOUNT OF PR PRIATION FOR r Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or �1 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 20_ e Title Cost distribution ledger classification if claim paid motor vehicle highway fund