165212 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 361418 Page 1 of 1
ONE CIVIC SQUARE GREGORY EPP
1 CARMEL, INDIANA 46032 3288 CICERO ROAD, LOT 49 CHECK AMOUNT: $162.50
NOBLESVILLE IN 46060 CHECK NUMBER: 165212
CHECK DATE: 10129/2008
DEPART ACC OUNT PO NUMBER INVOIC NUMBER AMOU DESCRIPTION
651 502 102008 162.50 OTHER EXPENSES
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S
t. CITY OF CARMEL Expense Report (required for all travel expenses)
HOIANP
EMPLOYEE NAME: l9 q e DEPARTURE DATE: �d ,2(J TIME: AM (a)
DEPARTMENT: S r cav RETURN DATE: p TIME: AM PM
REASON FOR TRAVEL: C GN>,'f cd EnAce DESTINATION CITY: D
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
_iof2 32.50 32.50
a of 09 6 5- ocl 65.00 0
S.oU 6 .Od
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.110
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
Total $0 .00 $0.001 $0.00 $0.001 $0.00 $0.00 $0.00 $o•00 $0.00 $0.00 $0.00 1
0
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 9 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
1 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: 10
City of Carmel Form ERO6 Revision Date 1012.4/2008 Page 2
V) FINDIAY
Q THE UNIVERSITY OF FINDLAY
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Cert ofAchievement
awarded by
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SCHOOL OF ENVIRONMENTAL AND
EMERGENCY AGE ENT
to
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Greg Epp
for Successful Completion of
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CONFINED SPACE ENTRANT /ATTENDANTI SUPERVISOR WORKSHOP
(FULFILLS THE REQUIREMENTS OF 29 CFR 1910.146)
Ln 8 HOURS OF TRAINING
N OCTOBER 21, 2008
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N EXECUTIVE DIRECTOR INSTRUCTOR
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4M "Now
FINDIAY
Q THE UNIVERSITY OF FINDLAY
Certi j --m icate
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awarded by
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SCHOOL OF ENVIRONMENTAL
EMERGENCY MANAGEMENT
to
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Greg Epp
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for Successful Completion of
CONFINED SPACE ENTRY BASIC RESCUE WORKSHOP
(FOLLOWING 29 CFR 1910.146)
to 8 HOURS OF TRAINING
N OCTOBER 22, 2008
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N EXECUTIVE DIRECTOR INSTRUCTOR
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Form No 301- S(Rev o 1995) fAccounts ACCOUNTS PAYABLE VOUCHER
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
Signature Title
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.
19 1
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT ACCT.
CARMEL, INDIANA NO
l Q Favor Of
Total Amount of Voucher
Deductions
/0900
04 70 Ool 6 Sd
Amount of Warrant
Month of 19
Acct.
VOUCHER RECORD No.
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
80YCE FORMS SYSTEMS 1 -800- 382 -8702 325