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Home My WebLink About162353 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1 ONE CIVIC SQUARE DOUGLAS HANEY CARMEL, INDIANA 46032 C/O DEPT OF LAW CHECK AMOUNT: $537.61 C/O DEPT OF LAW CHECK NUMBER: 162353 CHECK DATE: 8/7/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO UNT DESCRI 1180 4343002 537.61 EXTERNAL TRAINING TRA f te e* '4eg CITY OF CARMEL Expense Report (required for all travel expenses) NDIANp EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 06/19/08 AM DEPARTMENT: Law Department RETURN DATE: 06/20/08 TIME: PM REASON FOR TRAVEL: stematic Code Enforcement Worksh DESTINATION CITY: Lebanon, Indiana EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Date Transportation Gas/Tolls/ Lodging Meals Misc. Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 0.00 June 19 $19.00 $184.24 00 $293.2 20, 2008 $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 $19.00 $184.24 $0.00 $0.00 $0.00 $0.00 $90.001 $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. Director Signature: Date: City of Carmel Form ER Revision Date 7/21/2008 Page 1 \.c Attention: Hampton Guest 105 S. Meridian St. Indianapolis, IN 46225 If the debit /credit card you are using for check -in is attached to a bank or Phone 317 261 -1200 Fax 317 261 -1030 checking account, a hold will be placed on the account for the full anticipated dollar amount to be owed to the hotel, including estimated incidentals, 0 www.hamptondt.com through your date of check -out and such funds will not be released for 72 hours from the date of check -out. Initial: HANEY, DOUGLAS name address room number: 929 /KXTD 49 HAWTHORNE DR arrival date: 06/19/087:22PM departure date: 06/20/08 Initials_ CARMEL, IN 46033 adult /child: 1/0 room rate: 160.55 Initials RATE PLAN S -AAA HH #864254159 GOLD AL: NW #061240012 CAR: The management is not responsible for any valuables not secured in safety deposit boxes provided at CONFIRMATION NUMBER 88059719 the front office, nor theft or damage to vehicles parked on the premises. I agree that my liability for the charges is not waived and agree to be held personally liable in the event That the indicated person, company or association fails to pay for any part of the full amount of such charges. I hearby agree to vacate the accommodations assigned by 12 noon on the departure date printed above after that time authorize you to remove my property thereof and release you from any liability from any removal. 06/20/08 PAGE 1 "I have requested weekday delivery of USA TODAY. If refused, a credit of $0.75 will be applied to my account.' n the event of an emergency, I or someone in my party, require special evacuation assistance due to a physical disability. Please indicate yes by checking here: signature: w is ��e ,sr� J �z —a 06/19/08 1269429 VALET PARKING $14.00 }��o 06/19/08 1269590 GUEST ROOM $160.55 06/19/08 1269590 ROOM TAXES $25.69 06/20/08 1269664 ($200.24) BALANCE $0.00 EXPENSE REPORT SUMMARY 06/19/08 STAY TOTAL ROOM TAX $186.24 $186.24 MISCELLANE DUS $14.00 $14.00 DAILY TOTAL $200.24 $200.24 �I_ 1 Hilton HHono s R) sta s ost to o nt with n 72'hours of checkout.,To chec.:. our.. e rni0 s for r r f u� this sta `.or.a d3� 'a�i btt4'�'9�.44iftbrY' 41�'I� dtol�ETDG19'e, tom t s account no. Hit the road this weekend and take time out for you! Visit fa i1AAie9c har*ust to eftadii0thgb3noVisit hamptoninn.com or call 1- 800 HAMPTON. VS *7097 6/19/2008 354004 A card member name authorization initial HANEY, DOUGLAS 02523A establishment no. and location �Obllshment aBmes to U—mlt W .a.d halm_. ro, yment purchases services n f r r— IF�' I I r— taxes b I II r� g p tips mist. J A signature of card member total amount 200.24 X 'r 1 ^N '1�/ ``J CONRAU O.l Ga 11t1& thanks TheffiltW`t�'alnii HA) DUl1RLETRE E' .u�r.. G`�GEIIYICrlIR71' �t1n F5 C i ty. PAGE /f l RTIFIC RETAIL TAX EXEMPT 1 CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER f F 7 FEDERAL EXCISE TAX EXEMPT �r 35- 60000972 J/ ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL INDIANA 46032- 2584' VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION i SHIP VENDOR ,.f TO CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION C'�./ ✓t.•l/'6 1. frv' �i�,0 l m"11-1111'1111"�"lllllp in Al g Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT f ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT L` "1 r LLE� �f r5 PAYMENT o2 'e A P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. C �P GLr NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND f VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE r AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. „J CLERK- TREASURER DOCUMENT CONTROL NO A. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO...-_......_-._..--_-- ALLOWED 20 IN THE SUM OF ON COUNT OF APPRO RIATION FOR a Board Members PO# or INVOICE NO. ACCT #(TITLE AMOUNT I hereby certify that the attached invoice(s), or n 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 l� 20 O Title a ure Cost distribution ledger classification if claim paid motor vehicle highway fund of G4 Q,,RT.. "k .1 3 CITY OF CARMEL Expense Report (required for all travel expenses) !NOIANP EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 05/21/08 AM DEPARTMENT: Law Department RETURN DATE: 05/22/08 TIME: PM REASON FOR TRAVEL: stematic Code Enforcement Worksh DESTINATION CITY: Lebanon, Indiana EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Date Transportation Gas/Tolls/ Lodging Meals Misc. Total Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem $0.00 5/21/08 $171.37 $30.00 $201.37 5/22/08 $60.00 $60.00 $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 $171.37 $0.00 $0.00 $0.00 $0.00 $90.00 $0.00 c 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: Date: A5 �DO City of Carmel Form ER06 Revision Date 7/21/2008 Page 1 101 EASTJ,EFr ry r Ad ti l LOUISVILLE, KY 40202 U S A TELEPHONE 502-585-2200 FAX 502-584-5657 off, icial sponsor U.S. Olympic- Team HANEY, DOUGLAS, name room number: 324 /KXLX• 49HAWTHORNE-DR ''address i. arrival date: 05/21/086:55PM.. departure date. 05/22/08-. CARMEL;.IN 46033 adult/chlld room rate 1/0. U.S, 149.00: f the debiticre8lt car :you are using forcheck in is attached to a bank or'checking account: a hold will IkATE'PLAN LV2 be placed cni the accdunt.for the.full aniinpited dollar amount to be owed to the hotel, including HH# 864254159 GOLD estimated incidentals, through your.date of check -0urand suchfunds will not be released f6i72 business AL: NW #061240012 hours from the date ,of'check out orcnger at t e discretion of your.fmanaal`iristitution BONUS AL: CAR: 'Rates subjectto applicable sales occupancy, or other taxes. Please do not leave any_money dritems of value unattended in CONFIRMATION NUMBER 84517622 your room. A "safety deposit box is available for you in the lobby I agree that my liability for this bill is not waived and agree tobe held personallyiiable in the event thatthe indicated person, company or. association fails topay for any part or the full amount of.ihese charges. I have requested weekday delivery of USA TODAY. If refused, a credit of $.75 will be applied to 05/22/08. PAGE 1 my account. In the event of an emergency, 1, or someone in my.party, require special evacuation due to a physical disability. Please indicate yes by checking here: SICJ nature s. slim 05/21/08 378190 GUEST ROOM $149.00 05/21/08 378190 STATE SALES TAX $8.94 05/21/08 378190 CITY SALES TAX $11.85 05/21/08 378190 STATE OCCUPANCY TAX $1.58 WILL BE SETTLED TO $171.37 EFFECTIVE BALANCE OF $0.00 EXPENSE REPORT SUMMARY 05/21/08 STAY TOTAL ROOM TAX $171.37 $171.37 DAILY TOTAL $171.37 $171.37 You have ea ned approximately 1862 HHonors points and approximately 149 Iles with Northwest Airlines fort is stay. For reservations and to check your point balance, visit hilt nfamily. com. Hit the road his weekend and take time out for you! Visit family, friends and ju t take time to play. Visit hamptommn. om.orcall1- 800 HAMPTON.; for reservations call T.800.hainpton or visit us online at WWW.hampton.com account no. date of charge folio /check no. card member name authorization 120487 A establishment no. and location establishment agrees to transmit to card holder for payment purchases services taxes tips mist. signature of card member total amount X Pip Cu Car RT A RE 003 0155 00 PAGE CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER A FEDERAL EXCISE TAX EXEMPT p� �slyn `9) "G'G'Lt/ 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A1P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER,DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 4 VENDOR SHIP TO CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION T T -4`• Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. �dlr •�'U� NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPRO_aRIQT.I,ON SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. Z�K.,+G��'G/ THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE t �J AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. l 2 6 4 CLERK TREASURER DOCUMENT CONTROL NO A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 r C, IN THE SUM OF ON A COUNT OF APPR RIATION FOR o0 Board Members PO# or INVOICE NO, ACCT #/TITLE AMOUNT aEn.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the l materials or services itemized thereon for which charge is made were ordered and received except 20 natu Title Cost distribution ledger classification if claim paid motor vehicle highway fund