198330 06/09/2011DEPARTMENT
CITY OF CARMEL, INDIANA
ONE CIVIC SQUARE
CARMEL, INDIANA 46032
VENDOR: 080501
CINDY SHEEKS
13791 LAREDO DRIVE
CARMEL IN 46032
ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
Page 1 of 1
CHECK AMOUNT: $624.34
CHECK NUMBER: 198330
CHECK DATE: 6/9/2011
101 5023990 624.34 SBOA TRAINING
Date
Transportation
Gas/Tolls/
Parking
Lodging
Meals
Misc.
Total
$25.00
Air -fare
Car Rental
Other
Breakfast
Lunch
Dinner
Snacks
Per Diem
6/6/11
$25.00
6/7/11
$50.00
$50.00
6/8/11
$358.38
$50.00
$408.38
$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
$0.00
$358.38
$0.00
$0.00
$0.00
$0.00
$125.00
$0.00
$48338
CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
EMPLOYEE NAME: _CINDY SHEEKS DEPARTURE DATE: 2 (I TIME: r 7 AM (OD
DEPARTMENT: (L,V1 1 6 RETURN DATE: (0 1 I TIME: 3 AM
REASON FOR TRAVEL: Sol C I Uvl DESTINATION CITY: Vern 0 /It
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
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.
Director Signature:
City of Carmel Form ER06
Revision Date 6/9/2011
Date:
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:
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 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 ER06
Revision Date 6/9/2011 Page 2
STATE OF INDIANA
AN EQUAL, OPPOR'T'UNITY EMPLOYER
v*,
CERTIFICATE
STATE, BOARD OF ACCOUNTS
302 WEST WASHINGTON STREET
ROOM t4I8
INDIANAPOLIS. INDIANA 46204 -2765
Telephone: (317) 232 -2513
Fax: (317) 232-4711
Web Site: www.in.gov /sboa
I hereby certify that Cindy Sheeks, Deputy Clerk, City of Carmel, Indiana attended a School for
City Clerks, City Controllers and City and Town Clerk- Treasurers in Merrillville, Indiana, on June 7 and 8,
2011, called by the State Examiner, pursuant to Indiana Code 5- 11 -14, and is entitled to mileage at a rate
per mile determined by the city or town council to the person furnishing the conveyance, for each mile
necessarily traveled to the place of the meeting and return, as provided by law.
Reimbursement for lodging is also authorized for the nights preceding the meeting dates in an
amount not to exceed the hotel's single room rate. Reimbursement for meals purchased while attending
the meeting in an amount determined by the city or town council is also authorized.
STATE BOARD OF ACCOUNTS
4 7 ,7/
Bruce A. Hartman, CPA
State Examiner
(This certificate is to be attached to an accounts payable voucher and filed in the Controller's or Clerk
Treasurer's office for payment from the General Fund in the same manner as other claims. No
appropriation is required for payment of the expense.)
Residence
Inn`
karnott.
C. Sheeks
Arrive: 06Jun11 Time: 08:40PM
Date Description
Depart: 08Jun11
06Jun11 Room Charge
06Jun11 Occupancy Sales Tax
06Jun11 State Occupancy Tax
07Jun11 Room Charge
07Jun11 Occupancy Sales Tax
07Jun11 State Occupancy Tax
08Jun11 Visa
Card VIXXX)000000(XX1962 /XXXX
Amount: 358.38 Auth: 98929C Signature on File
This card was electronically swiped on 06Jun11
Residence Inn by Marriott 8018 Delaware Merrillville IN 46410
Merrillville P 219.791.9000
Room: 206
Room Type: ONBR
Number of Guests: 1
Rate: $159.99 Clerk:
Time: Folio Number: 85142
Charges Credits
159.99
8.00
11.20
159.99
8.00
11.20
Balance: 0.00
358.38
Rewards- Account XXXXX3989. Your Rewards points /miles earned on your eligible earnings will be credited to your
account. Check your Rewards Account Statement or your online Statement for updated activity.
As requested, a final copy of your bill will be emailed to you at: CSHEEKS@CARMEL.IN.GOV. See "Internet Privacy Statement"
on Marriott.com.
ate% Payee
Purchase Order No.
Terms
Date Due
Invoice
Date
Invoice
Number
Description
(or note attached iinvoice(s) or bill(s))
Amount
Peidllb(V
6, (10{. biG,
Tr
R.3K.
Total
`4-28,3
Prescribed by State Board of Accounts
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.
City Form No. 201 (Rev. 1995)
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.
PO# or
DEPT.
nA CAS
37 0 1 L.fiadb 7:DY
(.N Lk,03
ON ACCOUNT OF APPROPRIATION FOR
INVOICE NO.
ACCT #!TITLE
Cost distribution ledger classification if
claim paid motor vehicle highway fund
AMOUNT
ALLOWED 20
IN SUM OF
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
Title
Board Members
Clerk Treasurers Dinner on 6/7
Sheeks, Cindy L
From: Mills, Carl [Carl.Mills @53.com]
Sent: Thursday, June 02, 2011 2:31 PM
To: Mills, Carl
Subject: Clerk Treasurers Dinner on 6/7
We will be having our dinner on Tuesday night, I will meet people in the lobby of the hotel
around 5:45 (Central time) and we will carpool to dinner. Directions to dinner are included at
the bottom of this invitation. If you are not able to attend please let me know,
I look forward to seeing everyone at the conference,
Carl S. Mills
Vice President
Senior Relationship Manager
Public Funds
251 N. Illinois Street Suite 1000
Indianapolis,Indiana 46204
317 383 -2126
Carl.Mills@53.com
Dinner reservations set for 6:00 pm on June 7th
I v> orwatlow
6/6/2011
455 E. 84th Dr.
Merrillville, IN 46910
Phone Numbers
Page 1 of 2
Clerk Treasurers Dinner on 6/7 Page 2 of 2
219 -736 -5000
219 736 -2203
Fax -219 -756 -3454
800 E 81st Ave Merrillville, IN 46410
6/6/2011
Reservation by Phone Only'
Hours
Lunch
Monday- Friday 11:30a.m. to 2:30p.in.
Saturday 11:30a.m. to 2:OOp.rn.
Dinner
Monday- Thursday 5:OOp.m. to 9:00p.nz.
Friday Saturday 5: OOp. m. 0: 30p. m.
Closed Sundays
1. Head west on E 81st Ave toward Rhode Island St 0.2 mi
2. Take the 1st left onto Rhode Island St 0.1 mi
3. Turn left toward Connecticut St 0.5 mi
4. Take the 2nd left onto Connecticut St 400 ft
5. Take the 1st left onto E 84th Ave 0.1 mi
6. Take the 1st right onto Connecticut St Destination will be on the left 187 ft
455 E 84th Dr Merrillville, IN 46410
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Merrillville Map: Directions to Star Plaza Merrillville IN Page 1 of 2
Driving Directions Results
Residence Inn Merrillville
8018 Delaware Place
Merrillville, Indiana 46410 USA
Starting Location
13791 laredo drive
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IN US 46032
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Phone:
Fax:
Sales:
Sales fax:
Thank you for choosing Marriott. We look forward to seeing you soon.
Directions
Depart Laredo Dr toward Marana Dr
1. Turn right onto Marana Dr
2. Turn left onto Roswell Dr
Ending Location
Residence Inn Merrillville
8018 Delaware Place
Merrillville, Indiana 46410 USA
Phone: "1 219 791 9000
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ATTENTION: We do our best to present accurate driving directions, generated from the most current mapping services available.
However, new road construction and highway modifications may result in some discrepancies.
miles
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http: /www.marriott.com/hotels/ maps/ directions- results.mi ?startLocation= Starting +Location &endLocation... 6/6/2011
Merrillville Map: Directions to Star Plaza Merrillville IN Page 2 of 2
Directions miles
3. Turn right onto Eglin Dr 0.1
4. Road name changes to Old Meridian St 0,0
5. Turn right onto US -31 South N Meridian St 4.2
6. Take ramp right and follow signs for 1 -465 West US -52 West US -421 North 5.5
7. Keep straight onto 1 -865 West US -52 West 4.8
8. Keep straight onto 1 -65 North US -52 West 123.3
9. At exit 253, take ramp right for US -30 toward Valparaiso Merrillville Schererville 0.4
10. Turn left onto US -30 West E 81ST Ave 0.6
11. Turn right onto Connecticut St 0.1
12. Turn right onto E 80TH PI 0.2
13. Turn right onto Delaware PI 0.0
Arrive at Delaware PI
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Prescribed by State Board of Accounts
DATE
20
(Office, Board,
(Governmental Unit)
partment or Institution)
MILEAGE CLAIM
TO
On Account of Appropriation No.
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
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
General Form No. 101 (1955)
L E for 7(Z{Ak( 0
DR.
LIM I,
FROM
TO
ODOMETER READING*
Point
I lit
Auto License No.
Point
Start
Finish
NATURE OF BUSINESS
TOTALS
AUTO MILES
TRAVELED
2:76.447
MILEAGE
PER MIL
61
E
Claim No. Warrant No.
IN FAVOR OF
6,ar .c eA0,14___c
On Account of Appropriation No. ;Zb for
No Fvo
Allowed ,20
in the sum of
(Board or Commission)
FILED
(Official Title)
I have examined the within claim and
hereby certify as follows:
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently
Disbursing Officer
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