HomeMy WebLinkAbout165071 10/21/2008 �w CITY OF CARMEL, INDIANA VENDOR: 065950 Page 1 of 1
ONE CIVIC SQUARE DIANA CORDRAY
CARMEL INDIANA 46032 11843 STONEY BAY CIRCLE CHECK AMOUNT: b950.36
CARMEL IN 46933 -9501
CHECK NUMBER: 165071
f CHECK DATE: 10/2112008
DEPAR TMENT ACC P O NUM INVOICE NUMBE AM D
101 5023 310.56 SBA TRAINING
1701 4343004 639. -TRAVEL PER DIEMS
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CITY OF CARMEL Expense Report (required for all travel expenses)
��!NDIAkPi EXHIBIT A
EMPLOYEE NAME: ta'1e-t C draA4 DEPARTURE DATE: Oa c TIME: /d; AM PM
DEPARTMENT: `C r RETURN DATE: &4'j d09 TIME: AM .M
REASON FOR TRAVEL: f DESTINATION CITY: V r
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT L T 1WR L PER DIEM
Transportation Gas /Tolls/ Meals
Date Lodging Misc. Total'
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
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DIRECTOR'S STATE T: 1 hereby affirm t at 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 4 ER06 Revision Date 10/17/2006 Page 1
d STATE OF INDIANA
a b AN EQUAL OPPORTUNITY EMPLOYER STATE BOARD OF ACCOUNTS
302 WEST WASHINGTON STREET
ROOM E418
INDIANAPOLIS, INDIANA 46204 -2765
Telephone: (317) 232 -2513
Fax: (317) 232 -4711
Web Site: www.in.gov /sboa
CERTIFICATE
I hereby certify that, Diana Cordray Clerk Treasurer
(Name) (Title)
City of Carmel Indiana attended a School for City Clerks, City Controllers and City and
(City or Town)
Town Clerk- Treasurers in Middlebury, Indiana, on October 9, 008, ailed by the State Examiner,
pursuant to IC 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 meeting and
return, as provided by law.
For those persons residing fifty (50) miles or father from the meeting site, reimbursement for
lodging is also authorized for the night preceding the meeting date 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.
STAT ARID OF, OUNTS
Bruce artman, 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.)
Essenhaus Inn Conference Center Page 1 of 1
P.O. Box 1217
Middlebury, IN 46540
574- 825 -9471 574- 825 -1303
wivw.essenhaus.com
Diana Cordray Sheeks, Cindy R Folio`iC C Balance,.,
One Civic Square 311 110847 10/08/2008 10/09/2008 0.00
Carmel, IN 46032
Master Folio
bate RoomDescrEption�_ r Chargest its Balance
7.a. U r-w: ,ate. „ems
10108/2008 311 Room Taxable 94.00 0.00 94.00
i
10108/2008 311 Sales Tax 7.000% 6.58 0.00 100.58
10/08/2008 311 i Hospitality Tax 5.000% 4.70- 0.00 105.28
10/09/2008 j 311 I Transfer Credit Transfer 110847/110848 0.00' 105.28 0.00
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TR Thank you for staying with us!
10109!2008 10 '04 AM
Essenhaus Inn Conference Center Page 1 of 1
P.O. Box 1217
Middlebury, IN 46540
574- 825 -9471 574 825 -1303
www.essenhaus.corn
Diana Cordray Folio Checkln Checkput Balance
I Room
One Civic Square 310 110848 10/08/2008 10/09/2008 0.00
Carmel, IN 46032
Master Folio
Date w' Room IDescripti in Char es r Crecllts Ba lance
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10/08/2008 310 Room Taxable 94.00 0.00 94.00
10/08/2008 310 Sales Tax 7.000% 6.58 0.00 100.58
10/08/2008 310 Hospitality Tax 5.000% 4.70 0.00
10/09/2008 310 Transfer Debit Transfer 110847/110848 105.28 0.00 210.56
10/09/2008 310 AP: 182691 0.00 210.56 0.00
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TR Thank you for staying with us!
10109/2008 10,04 AM
J
CITY OF CARMEL Expense Report (required for all travel expenses)
laaiAw? EXHIBIT A
EMPLOYEE NAME: L 6 DEPARTURE DATE: &:�)Ua A TIME: AM PM
DEPARTMENT: T RETURN DATE: TIME: 3 AM I
REASON FOR TRAVEL:
P� ��XY' DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. °.'Total.
Air -fare Car Rental Parking Breakfast Lunch Dinner Snacks Per Diem
011 0.0
0 1 qf, b o x.06
p•
LEL 50-
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K r„ L +'iTYM. A' ,y, .n n .,1 �c'y b t:. a' Y� a� 'i�k� y� v i'H?a :F� S I
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: l
City of Carmel Form ER06 Revision Date 1011712006 Page 1
For questions regarding this folio, please call
A arnott Marriott Business Services toll -free 1- 866 435 -7627. GUEST FOLIO
SOUTH BEND 123 N St. Joseph Street, South Bend, Indiana 46601 574.234.2000 Marriott.com /SBNIN
943 CORDRAY /DIANA 120.00 10/15/08 12:00 4441 6119
Room Name Rate Depart Time ACCT GROUP
ACKG IACT 10/12/08 13:25
Type Arrive Time
7 200 S. MERIDIAN PASSPORT:
INDIANAPOLIS IN
Room 46225 payment
Clerk Address
DATE I REFERENCE CHARGES CREDITS BALANCE DUE
10/12 PARKING 444158 9.00
10/12 GRP -ROOM 943, 1 120.00
10/12 ROOMTX 943, 1 8.40
10/12 CITYTX 943, 1 7.20
10 /13.GRP -ROOM 943, 1 120.00
10/13 ROOMTX 943, 1 8.40
10/13 CITYTX 943, 1 7.20
10/13 PARKING #0444158 9.00
10/14 GRP -ROOM 943, 1 120.00
10/14 ROOMTX 943, 1 8.40
10/14 CITYTX 943, 1 7.20
10/14 PARKING #0444158 9.00
10/15 AX CARD $433.80
SETTLED TO: AMERICAN EXPRESS CURRENT BALANCE .00
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This statement is your only receipt. You have agreed to pay in cash or by approved personal check or to authorize us to charge your credit card for all amounts charged to
you. The amount shown in the credits column opposite any credit card entry in the reference column above will be charged to the credit card number set forth above. (The
credit card company will bill in the usual manner.) If for any reason the credit card company does not make payment on this account, you will owe us such amount. If you
are direct billed, in the event payment is not made within 25 days after checkout, you will owe us interest from the checkout date on any unpaid amount at the rate of 1.5%
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Signature X
7 -2955 Rev. 09/07 To secure your next stay, go to Marriott.com
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to WE KNOW YOU LIKE TO WRAP THINGS UP NEATLY.
Follow these simple steps to streamline the check -out process:
lO Call the front desk to inform us you'll be using Express Checkout.
O 2 Leave your key in the room if you do not have a car in the Garage.
If you are parked in our Garage and charged parking to your room, a
room key will be required to exit the Garage. Please swipe your room
key to exit and leave your room key in the drop box. (Overnight parking
is a $9.00 daily charge and can be paid with cash or credit at the gate.)
O 3 Keep the attached receipt for your records. It includes charges as of
2 a.m. today. (For charges incurred after 2 a.m., you can pay at the
point of sale, the front desk or, at your request, we'll mail you an
updated bill within 24 hours of your departure.)
Thank you for choosing Marriott. We hope your stay was as comfortable as
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A�1QQ OU
Accounts subject to credit approval.
y Restrictions and limitations apply. R C\N A R D S°
t The Marriott Rewards Visa Signature credit
G y o' o card is issued by Chase Bank USA, N.A.
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F E
AFFIDAVIT FOR EXPENSES
k
I, Diana L. Cordray, incurred expenses while on City business (National League of
Cities) for which a receipt was not possible. The following non- receipted expense(s)
are as follows:
September 10, 2008 Skycap at 1ndpls.Airp0rt $2.00
September 13, 2008 Shuttle tip to 'Denver 4.00
Total 6.00
September 15, 2008
kt—�& 6!t
151ana L. Cordray
Clerk Treasurer
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
l r
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
ON ACCOUNT OF APPROPRIATION FOR
C �L160 L� lid 6"
J b'1 f �2o�gb Board Members
P or c 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
20
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
EMPLOYEE NAME: DEPARTURE DATE: i_ TIM AM
AM P
DEPARTMENT: RETURN DATE: l TIME: 3 05 AM
REASON FOR TRAVEL: �A nx t DESTINATION CITY: GVIlro ra- Co
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc.
Parkin Tota[
Air -fare Car Rental Other g Breakfast. Lunch Dinner Snacks Per Diem
a or rt
s.
v.
A
MUM
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[DIRECTOR'S STATEME I hereby aff 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 ER06 Revision Date 10/17J2006 Page 1
13696 East Iliff Place Aurora, CO 80014
00
D O U B L E T R E L' Phone (303) 337 -2800 Fax (303) 337 -9691
Reservations
Name Address HOTEL www.doubletree.com or 1 -800- 222 -TREE
DFNVFk •.SOIMIFACT
CORDRAY, DIANA Room 602 /NK1D
11843 STONEY BAY CIR Arrival Date 09/10108 4:22PM
Departure Date 09/14/08
CARMEL, IN 460339501
US Adult/Child 110
Room Rate 99.00 C -FAI
RATE PLAN
G 2 C
AL: US #999L7R4
CAR:
CONFIRMATION NUMBER: 82672414
09/13/08 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT 1IIE1111�OI�dL1Lly
09/10/08 253514 *FITZGERALD'S BAR $4.24
09/10/08 253532 `RESTAURANT $37.43
09/10/08 253777 GUEST ROOM .00 Hilton
09/10/08 253777 ROOM TAXES $12.23
09/11/08 254379 GUEST ROOM $99.00
09/11/08 254379 ROOM TAXES $12.23
09/12/08 254757 "RESTAURANT $1281 CON RAD'
09112/08 255089 GUEST ROOM 99.00
09/12/08 255089 ROOM TAXES $12.2
09/13108 255178 ($388.17)
i
J
BALANCE $0.00 DOUBLETREe
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ry Hilton
Garden Inn
ACCOUNT NO. DATE OF CHARGE FOLIO NO.ICHECR NO. Hilton
VS "'4790 09/10/08 65905 A Grand Vacations Club'
CARD MEMBER NAME AUTHORIZATION INITIAL. 2W CORDRAY, DIANA 01673C HoKEaOCID
surrey
ESTABLISHMENT NO. LOCATION I:G'rAxusnnlrxr Arltels'ni"MANSMIT ro CAR[) ROFnrx FORI'Ay' r PURCHASES SERVICES
NUR-
TAXES
TIPS MISC. V c A
CARD MEMBER'S SIGNATURE
TOTAL A. \10UYT -388 1 7
X Official Sponsor
IN11WHANDINE ANDUOR S114VICM PURCHA5717 ON MIS CARD SNAIL NOT III: R]i-IJJ OR REIIIRNIJ> FOR A CASH RJTUNIJ. PA1TIrNI' DUE UPON RECE1111'