HomeMy WebLinkAbout166615 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 052000 Page 1 of 1
0 ONE CIVIC SQUARE CRAIG CARTER CHECK AMOUNT: $25.34
CARMEL, INDIANA 46032 109 EMERALD LANE
NOBLESVILLE IN 46060 CHECK NUMBER: 166615
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CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUM BER IN VOICE NUMBER AMOUNT DESCRIPTION
651 5023990 25.34 OTHER EXPENSES
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CITY OF CARMEL Expense Report (required for all travel expenses)
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2008 mileage reimbursement rate is 58.5 cents /mile
EMPLOYEE NAME: CRAIG CARTER DEPARTURE DATE: 11/18/2008 TIME: 8:30AM
DEPARTMENT: Utilities /Sewer RETURN DATE: 11/20/2008 TIME: 4:30PM
REASON FOR TRAVEL: 2008 INDIANA WATER ENVIR. ANNUAL CONF, DESTINATION CITY: INDPLS, IN
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
11/18/08 $12.58 $12.58
11/19/08 $12.76 $12.76
$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
Totall $0.001 $0.00 $0.00 $0.001 $0.001 $0.001 $25.34 $0.001 $0.001 $0.00 $0.00
DIRECTOR'S STATEMENT: 1 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 ER06 Revision Date 11/25/2008 Page 1
WASTEWATER OPERATOR CONTINUING EDUCATION To ensure proper credit, the
wastewater approval number
CREDIT REPORT MUST be provided.
State Form 51139 (R 1-06) Training Course Approval Number:
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT WVV 4-G1 1.5
Technical Contact Hours Earned:
29.5
General Contact Hours Earned:
15
INSTRUCTIONS—
In accordance with 327 IAG 5-22-17(c), the training provider must submit this form within thirty (30) days of the
conclusion of the wastewater treatment continuing education coul rse. Mail the completed form, to:
Wastewater Continuing Education Coordinator
Indiana Dept. of Environmental Management
100 N. Senate Ave Mail Code 65-42
Indianapolis, IN 46204-2251
Incomplete forms will be returned to the training course I provider for completion and resubmittal to IDEM.
Partial course credit shall not be given to instructors, speakers, or students participating in less than a complete
wastewater treatment continuing education course.
The training provider must retain a copy of this form for their records for a five (5) year period following the
presentation of each wastewater treatment continuing edu cation course.
Training providers are encouraged to provide a copy of the completed and signed credit reporting form to the
certified OPERATOR attending the entire wastewater operator continuing education course.
CERTIFIED OPERATOR INFORMATION
1. NAME-
2. ADDRESS (number and street):
/A
City: State: ZIP code: relephone number:
Nork: 2"
5
vlome/cer: M
Al 46 0 fo 0 .317- 5 71
Check here if this is an address change Email Address: 4%
'7
COURSE INFORMATION
3. NAME OF TRAINING COURSE:
Annual Conference 2�Q(Dq';-
4. NAME OF ORGANIZATION SPONSORING COURSE:
Indiana Water Environment Association
5. DATE(S) ATTENDED: LOCATION ATTENDED:
November 18-20, 2008 T Marriott East, Indianapolis
.7. TOTAL NUMBER OF CONTACT HOUR ATTENDED BY CERTIFIED OPERATOR AND VERIFIED BY 114STRUCTOR AND TRAINING
COURSE PROVIDER:
Technical contact Hours: General Contact Hours:
M to
1, the undersigned, certify under penalty of law that this document (and a' ny attachments) were prepared under my direction or
supervision and that the information submitted is, to the best of my knov�ledge and belief, true, accurate, and correct. I also understand
that any omissions or misrepresentations may result in the denial of continuing education credit for this course.
8. SIGNATURE OF INSTRUCTOR: 9. NAME OF INSTRUCTOR: C
7
Lj
1 6. SIGNATURE OF CERTIFIED OPERATOR:,,- I .11'. PRINTED INA ME OF ClEkTI11�1FID OPERATOR:
12. CONTINUING tDUCATION CREDIT HOURS ARE TO BE APPLIED TO:
Operator celfiffication number: class: Expiration date:
I 4f I /1,, 9
Operator certification number: Class: Expiration date:
VOUCHER 086762 WARRANT ALLOWED
520001 IN SUM OF
CRAIG CARTER
109 EMERALD LANE
NOBLESVILLE, IN 46060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Sr
Board members
PO INV ACCT AMOUNT Audit Trail Code
111808 01- 7042 -05 825.34
Voucher Total $25.34
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
52000
CRAIG CARTER Purchase Order No.
109 EMERALD LANE Terms
NOBLESVILLE, IN 46060 Due Date 12!112008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/1/2008 111808 $25.34
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 r�
Date er