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Home My WebLink About159299 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 065950 Page 1 of 1 ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: $491.07 o CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CARMEL IN 46033 -9501 CHECK NUMBER: 159299 CHECK DATE: 5/14/2008 DEPARTMENT ACC OUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP 1701 4343004 491.07 TRAVEL PER DIEMS �t� OF CqR 4n4�7Ry��F� CITY OF CARMEL Expense Report (required for all travel expenses) ��(NOIANp` r EXHIBIT A EMPLOYEE NAME: DEPARTURE DATE: TIME: apM DEPARTMENT: GT RETURN DATE: S� I D TIME: S AM PM REASON FOR TRAVEL: N LC, C .6 rm"utttr, DESTINATION CITY: 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 r g Breakfast Lunch Dinner Snacks Per Diem a� .1 t.` 5 't.0' 'S's murw� ,g� �«.3 i; ry F :i ;y �X. 5�� z .1",.� .r y�. f.- ST�^7, t. :;.t�&3a�.'r; ��xa, a ...u��.��a3>,s: >,.,s:�: r ,I.,�a -s: :�rr�.�;�. ._t_ ,i DIRECTOR'S STATE T: 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: �w City of Carmel Form ER06 Revision Date 10/17/2006 Page 1 t Hampton Inn- Brevard U S A 275 Forest Gate Drive o Pisgah Forest, NC 28768 official sponsor u.s- Olympic team Q�Q Phone (828) 883 -4800 Fax (828) 877 -5884 9 CORDRAY, DIANA name room number: 3291SXBL 11843 STONEY BAY CIR address arrival date: 051081084:18PM CARMEL, IN 46033 departure date: 05110/08 US adult /child: 110 room rate: $99.00 It the debiticredit card you are using for check -in is attached to a bank or checking account, a hold will E PLAN C NLC be placed on the account for the full anticipated dollar amount to be owed to the hotel, including RATE #99 L E R business hours from the date of check -out or longer at the discretion of your financial institution. BONUS AL: CAR: Rates subject to applicable sales, occupancy, or other taxes. Please do not leave any money or items of value unattended in Confirmation: 88384800 your room. A safe deposit box is available for you in the lobby. I agree that my liability for this bill is not waived and agree to be held personally liable in the event that the indicated person, company at association fails to pay for any part or the full amount of these charges. I have requested weekday delivery of USA Today. If refused, a credit of $0.75 will he applied to 05110/08 PAGE ,1 my account. In 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 hare: signature: 05/08/08 386119 GUEST ROOM $99.00 05/08/08 386119 ROOM TAXES $10.64 05/09/08 386273 GUEST ROOM $99.00 05/09/08 386273 ROOM TAXES $10.64 WILL BE SETTLED TO $219.28 EFFECTIVE BALANCE OF $0.00 You have ea nod approximately 2277 HHonors points and approximately 198 iles with US Airways for this stay. F or reservations and to check your point balance, visit hiltonfamil .com. Hit the road his weekend and take time out for you! Visit family, friends and ju t take time to play. Visit hamptoninn. om or call 1- 800 HAMPTON. kr." x m account no. date of charge folio /check no. 149171 A card member name authorization initial establishment no. and location establishment agrees to transmit to card holder for payment purchases services taxes tips misc. signature of card member X total amount Carey Indiana Limousines Departures 318845 Driver Vehicle Dennis Demille 177 Pick up date 05108/08 Service Sedan Pick up time 06:20 AM Flight Type Customer request Airline NW Northwest Name CORDRAY, DIANA Flight 693 Passengers 1 Flight Time 06:20 AM Flight City Memphis PICK -UP Carmel DROP -OFF IND Address 11843 STONYBAY CIR Address Carmel IN IN TEL (317) 201 -1010 Email None ALT TEL Instructions: XX- GRAY AND 116TH Base; fare 67.00 STC 6.70 Other 18.09 Gratuity 1 Total Fare 91.79 PAYMENT METHOD: adv no grt flight a Northwest Airlines nwa.eom. Travel Center Trip Summary and Receipt Page 1 of 2 i lmwaa „e 8 Send to Printer Trip Summary and Receipt *4BJJNX* Thank you for choosing Northwest Airlines! Check in and get your boarding passes online at www -nwa com within 24 hours of your flight or use a Northwest Airlines self- service airport kiosk, available throughout the U.S. and Canada. Receive a complimentary flight and gate status alert e -mail from Northwest, sign up now at My NWA_ Info. View the Terms .._and .._.C_..ond.itio.n that apply to your reservation. cur Review TS A Seity Requirements NWA Confirmation Number: 4BJJNX Passenger Name: CORDRAY /DIANAL E- Ticket Number(s): 0127163734985 Frequent Flyer Number: NW100104362341 Th followi flights are confi rmed: 1 day until d Date: Thursday, May 8 Flight: NW 693 Departs: Indianapoiis- Int'I, IN (IND) at 8:OOAM Arrives: Memphis- Int'I, TN (MEM) at 8:32AM Class of Service: Economy Class (L) Seat: 13 -B Aisle Flight Duration: 1 hour 32 minutes Approximate Miles: 382 Meal Service: None Aircraft: McDonnell Thursday, May 8 Flight: NW 5771 Departs: Memphis- Int'I, TN (MEM) at 9:15AM Arrives: Greenville /Spartanburg, SC (GSP) at 11:45AM Class of Service: Economy Class (L) Seat: 09 -B Aisle Flight Duration: 1 hour 30 minutes Approximate Miles: 433 Meal Service: None Aircraft: Canadair Regional Jet CRJ Note: "Operated by PINNACLE AIRLINES /NWA AIRLINK Date: Saturday, May 10 Flight: NW 5768 Departs: Greenville /Spartanburg, SC (GSP) at 12 :40PM Arrives: Memphis- Int'I, TN (MEM) at 1:10PM Class of Service: Economy Class (K) Seat: 09 -C Aisle Flight Duration: 1 hour 30 minutes Approximate Miles: 433 Meal Service: None Aircraft: Canadair_Region...l.,J..et C.R.J. Note: `Operated by PINNACLE AIRLINES /NWA AIRLINK Date: Saturday, May 10 Flight: NW 5720 Departs: Memphis- Int'I, TN (MEM) at 2:25PM Arrives: Indianapolis- Int'I, IN (IND) at 4:59PM Class of Service: Economy Class (K) Seat: 06 -C Aisle Flight Duration: 1 hour 34 minutes Approximate Miles: 382 Meal Service: None Aircraft: Canadair.._ Regi..o...nal._Jet_CR.J. Note: "Operated by PINNACLE AIRLINES /NWA AIRLINK Passenger Name: CORDRAY /DIANAL Receipt Information for your E- Ticket Number(s): 0127163734985 https: /www.nwa.com /cgi- bin /view_res. pro ?Pnr 4BJJNX& eticket _nurn 0127103734985 5/7/2008 Northwest Airlines nwa.com Travel Center Trip Summary and Receipt Page 2 of 2 E- Ticket Issue Date: March 28, 2008 Flight Origin- Destination Date Fare Basis Code Status NW 0693 IND -MEM 08May2008 _LR7QNV Available NW 5771 MEM -GSP 08May2008 LR7 Available NW 5768 GSP -MEM 10May2008 KR7NR Available NW 5720 MEM -IND 10May2008 KR7N_R Available Base Fare: USD303.27 Tax:22.74 Tax: 28.50 E- Ticket TOtal:USD354.51 Additional amount collected during ticket exchange: USD135.70 Method of Payment: Fare Calculation: 0 FC 8MAY IND NW X/MEM NW GSP Q23.26 183.26LR7QNV NW X /MEM NW IND 023.26 73.49KR7NR USD303.27END ZPINDMEMGSPMEM XT 14.00ZP 10.00AY 4.50XFIND4.5 A/C 135.70 Other Restrictions: NON REFUNDABLE- PENALTY FOR CHANGES Name /Place of Issue: THE TRAVEL AGENT /CARMEL IN Back ckD Northwest Airlines 2008 https: /www.nwa.com /egi- bin /vlcw_res. pro ?Pnr- 4BJJNX &eticket_num= 0127163734985 5/7/2008 Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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. ALLOWED 20 IN SUM OF I ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. 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 A 'i i� J. '9., 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund