160722 06/24/2008 I
CITY OF CARMEL, INDIANA VENDOR: 080501 Page 1 of 1
1 C
ONE CIVIC SQUARE CINDY SHEEKS HECK AMOUNT: $1,327.46
CARMEL, INDIANA 46032 13791 LAREDO DRIVE
CARMEL IN 46032 CHECK NUMBER: 160722
CHECK DATE: 6/24/2008
DEPARTMENT ACCO UNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIP
1701 4343004 1,301.20 GFOA
1701 4343004 26.26 MILEAGE
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of Cqq�
CITY OF CARMEL "Expense Repo (required for all travel expenses)
cN EXHIBIT A
EMPLOYEE NAME: DEPARTURE DATE: �D8 TIME: /�qv AM 0
DEPARTMENT: RETURN DATE: (0IIg a TIME: j -dU AM I
REASON FOR TRAVEL: t�l I YJ K�/ DESTINATION CITY: 4 (aadWAd o_
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM t/
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Taxi Tips Luggage Parking Breakfast Lunch Dinner Snacks Per Diem
6/14/08 $38.00 $25.00 $60.00 $123.00
6/15/08 $60.00 $60.00
6/16/08 $38.00 $60.00 $98.00
6/17/08 $24.00 $60.00 $84.00
6/18/08 $12.00 $8.00 $25.00 $110.00 $721.20 $60.00 $936.20
$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 $112.00 $8.00 $50.00 $110-001 $721.201 $0.00 $OAO $0,00 $0.00. $300.00 $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 ER06 Revision Date 6/19/2008 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
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:
City of Carmel Form ER06 Revision Date 6/19/2008 Page 2
r
V ,%arnott GUEST FOLIO
HOTELS RESORTS
1005 SHEEKS /CINDY 06Z18/08 11:00 1087 6337
Room Name Rate part rme ACCT GROUP
DBOF GOVERNMENT FINANCE 0 06/j4/08 13.56
Type Time
73 180 NORTH MICHIGAN A PASSPORT:
CHICAGO IL
Room 60601 Payment M R
Clerk Address
DATE REFERENCE CHARGES CREDITS BALANCE DUE
06/14 ROOM 1005, 1 161.00
06/14 STATE TX 1005, 1 9.66
06/14 LOCAL TX 1005, 1 8.05
06/15 BUS CNTR 34271005 6.36
06/15 ROOM 1005, 1 161.00
06/15 STATE TX 1005, 1 9.66
06/15 LOCAL TX 1005, 1 8.05
06/16 ROOM 1005, 1 161.00
06/16 STATE TX 1005, 1 9.66
06/16 LOCAL TX 1005, 1 8.05
06/17 ROOM 1005, 1 161.00
06/17 STATE TX 1005, 1 9.66
06/17 LOCAL TX 1005, 1 8.05
06/18 721.20
TO BE SETTLED TO: 4W CURRENT BALANCE .00
THANK YOU FOR CHOOSING MARRIOTT! TO EXPEDITE YOUR CHECK —OUT,
PLEASE CALL EXTENSION 6558 OR PRESS "MENU" ON YOUR
TV REMOTE CONTROL TO ACCESS VIDEO CHECK —OUT.
WANT YOUR FINAL HOTEL BILL BY EMAIL? JUST ASK THE FRONT DESK!
SEE "INTERNET PRIVACY STATEMENT" ON MARRIOTT.COM
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%
per month (ANNUAL RATE 18 or the maximum allowed by law, plus the reasonable cost of collection, including attorney fees.
Signature X
7 -2955 Rev. 09/07 To secure your next stay, go to Marriott.com.
BE REWARDED FOR YOUR TRAVEL PERFORMANCE.
A anrooff Earn valuable points toward free vacations or airline miles every time
R S. you stay with the Marriott® family of hotels. With more than 2,700 locations
worldwide, you're bound to rack up the Rewards quickly. Stop by the front
desk, call guest services at 1.800.249.0800 or log on to
MarriottRewards.com to enroll.
WE KNOW YOU LIKE TO WRAP THINGS UP NEATLY.
Follow these simple steps to streamline the check -out process:
O Call the front desk to inform us you'll be using Express Checkout.
O Leave your key in the room or in one of the drop boxes at the front desk.
0 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
it was productive.
MAXIMIZE YOUR REWARDS
1- WITH A MARRIOTT REWARDS VISA CARD.
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Log on to MarriottRewards.com /visa to apply or to learn about the benefits of other
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Restrictions and limitations apply. C VV A P"p S�
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l See MarriottRewards.com /visa for pricing
and rewards details. The Marriott Rewards
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G e. to U.S. residents only.
Northwest Airlines WorldWeb nwa.com boarding document page 1 Page 1 of 1
[Segment] Sec. Nr: [1] 11
�1M
�waxom check -in.
Boarding Pass
Name: SHEEKSICYNTHIAL Confirmation 31ZCPV E- Ticket 0127129565121
Date Flight From To Time Cabin Seat Gate
1 18Jun NW 4727 Ft. Lauderdale Indianapolis Board: 3:45 PM Coach
Operated by Pinnacle Airlines Depart: 4:10 PM 03 -B C8
Arrive: 7:10 PM
Frequent Flyer M NW 484
Requests:
Note: Gates may change check monitors
Checking luggage? Use the airport Self- service Check -in Kiosks and select the "nwa.com
Luggage Check" option, or curbside check -in (fees may apply).
The recommended arrival time at the airport prior to departure is 75 minutes for t ravel
within-the-U.S_ and 2 ho for tr avel outside the U.S. Please be on board the aircraft at
least 15 minutes prior to departure for flights within the U.S. and at feast 30 minutes prior
to departure for flights outside of the U.S.
Customers traveling outside of the U.S. are required to insert a passport at an airport kiosk
or present it to an agent.
https:// www. nwa .Com/AOPSSDWeb /ici /PrintBp.do 6/18/2008
Page 1 of 2
Sheeks, Cindy L
From: travel @expedia.com
B ent: Monday, April 14, 2008 8:08 PM
To: Sheeks, Cindy L
Subject: Expedia travel confirmation Fort Lauderdale, FL Jun 14, 2008 (Itin# 123432467349)
Travel Confirmation
Thank you for booking your trip with Expedia. This email is your receipt for the travel item(s) you just
booked; a complete itinerary that includes all applicable ticket numbers, reservation IDs,etc. will follow
in the next 4 days.
Remember that you can always view your tin_e_ra- ry._onl -ine for the most up -to -date information. Our
interactive demo can show you how easy it is to get information about your itinerary.
Did you know about all the ways you can earn ThankYou Points on
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Although this itinerary doesn't qualify for ThankYou Points, you can still earn polkw*`
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Your ticket purchase has not been confirmed by the airline. Please check your complete itinerary after 24 hours have
assed for ticket confirmation information.
Flight: Indianapolis to Fort Lauderdale Total ticket cost: $235.00
Taxes &Fees: $25.00
0 heeler name: CYNTH SHEEKS
Airfare total: $260.00
Indianapolis (IND) to Fort 6114108 12:40 pm 3:25 pm Northwest Operated
Lauderdale (FILL) By: NORTHWEST
AIRLINK
Fort Lauderdale (FLL) to 6/18108 4:10 pm 7:10 pm Northwest Operated
Indianapolis (IND) By: NORTHWEST
AIRLINK
View itinerary for complete and up -to -date trip details, or to make changes online.
Customer Support
Itinerary number: 123432467349
If you have questions about your reservation, fill out our itinera assistance form. We'll respond within
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6/2312008
hwaib.d by Slm. Board o: A c cants.
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MILEAGE CLAM
(&V FNTAL UNIT) TO DR.
ON ACCOUNT OF APPROPRIATION NO.�O
(OFFICE. BOARD. DEPARTMENT OR INSTITUTION)
DATE READING+ START FIN FROM TO I SPEEDOMETER
AUTO MILEAGE
MILES
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AUTO LICENSE NO. TOTALS
+SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155. Acts 1953. I hereby certify that the foregoing account is just and correct. that the amount claimed is legally due. after allovving all just creel
and that no part of the same has been paid.
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Claim No. Warrant No. I have examined the within.. claim cind.hereby
IN FAVOR OF certify as follows:
That it is in proper 'form.
That- it is duly authenticated as required
by law.
That it is based upon statutory authority.
That it s apparentiy t correct
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
l 36
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Pots 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
Z VkZW
0
Ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund