The URL can be used to link to this page

Home My WebLink About202058 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 027850 Page 1 of 1 ONE CIVIC SQUARE JAMES BRAINARD CHECK AMOUNT: $1,163.06 CARMEL, INDIANA 46032 *;ro CHECK NUMBER: 202058 CHECK DATE: 9127/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION 1160 4343001 54.00 TRAVEL FEES EXPENSE 1160 4343003 914.06 TRAVEL LODGING 1160 4343004 195.00 TRAVEL PER DIEMS Affidavit 1, James Brainard, certify that I paid $54.00 for parking charges at Indianapolis International Airport on September 22, 2011. James Brainard Dafe: September 27, 2011 CITY OF CARMEL Expense Report (required for all travel expenses) �o�a��✓ EXHIBIT A EMPLOYEE NAME: DEPARTURE DATE: TIME: LD C) AM PM DEPARTMENT: Y mAm W 11 5 2. RETURN DATE: 1 y� TIME: 1\ l ,n REASON FOR TRAVEL: r S Oar" "CL:sjnrS DESTINATION CITY: W QShwr� C EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM JZ Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem 5 5. C c� r Sa. CoS.oc7 J1Zr.l�.1� $0.0 $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 o.ao Total $0.001 $0.00 $0.001 $0.001 $0.00 $0.001 $0.00' Enjimaal 111— 11 7 LAWAU 5 .ou U5a.0 LQ lqs -cam 11 L93.0(� DIRECTOR'S STATEMENT: I her affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: ,—,7 City of Carmel Form ER06 Revision Date 9/25/2011 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 $65 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 $32.50 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 $32.50 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 $65 for out -of -state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: 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. 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 ERO6 Revision Date 9125/2011 Page 2 Pagel of 2 Kibbe, Sharon From: Martin, Candy Sent: Wednesday, August 10, 2011 11:57 AM To: Kibbe, Sharon Subject: FW: 2011 Fall Leadership Meeting FYI I have registered the Mayor for the USCM conference in September 19 -21 in Washington DC. Below is the confirmation for your records. Thanks Candy Martin City of Carmel Office of the Mayor 317 571 -2401 Direct 317- 844 -3498 Fax From: USCM Meetings Department [ma ilto: meetings@ usmayors.org] Sent: Wednesday, August 10, 2011 11:44 AM To: Brainard, James C; Martin, Candy Subject: 2011 Fall Leadership Meeting The United States Conference of Mayors Fall Leadership Meeting September 19 -21, 2011 The Fairfax at Embassy Row Washington, DC 8/12/2011 Page 2 of 2 Thank you for submitting your registration online. Confirmation Number: f11137096 Submission Date: 811012011 11:36:11 AM REGISTRATION INFORMATION First Name: JAMES Last Name: BRAINARD Title: Mayor Organization: City of Carmel Address: One Civic Square Address 2: City: Carmel State: IN ZIP: 46032 Phone: 317- 571 -2401 E -Mail: jbrainard @carmel.in.gov Fax: 317- 844 -3498 Hotel Reservation Information A block of rooms has been set aside at the following hotel The Fairfax at Embassy Row 2100 Massachusetts Avenue, NW Washington, DC 20008 (202) 293 -2100 Single /Dou ble:$285 Taxes: 14.5% IMPORTANT: Room reservations must be made by calling the hotel directly at (888) 627 -8439. Please identify yourself as an attendee of The U.S. Conference of Mayors meeting to ensure receiving the group rate. Reservations must be confirmed with the hotel by Friday, August 26, 2011. Reservations must be guaranteed to a credit card for the first night's room deposit. Reservations must be cancelled 72 hours prior to arrival. 8/12/2011 cc ory THE UNITED STATES CONFERENCE OF MAYORS c 1620 EYE STREET, NORTHWEST A WASHINGTON, D.C. 20006 O i TELEPHONE (202) 293 -7330 FAX (202) 293 -2352 URL: www.usmayors.org August 3, 2011 TO: The Mayor FROM: Tom Cochran CEO and Executive Director SUBJECT: USCM Fall Leadership Meeting, Washington, DC: September 19 -21, 2011 On behalf of Conference President Los Angeles Mayor Antonio R. Villaraigosa, I am pleased to provide you registration /hotel information for our upcoming Fall Leadership Meeting in Washington, DC. Our meeting is timed for us to have maximum impact on the FY 2012 appropriations process, as well as the newly announced joint congressional committee being charged to identify an additional $1.5 trillion in deficit reductions by November 23. The meeting will be held at the Fairfax Embassy Row Hotel. Please see attached registration form for hotel information. The outline for the meeting is as follows: Monday, September 19 Opening Reception Tuesday, September 20 Meetings /Hill Visits /Evening Event Wednesday, September 21- Meeting through 11:00am We face many challenges in Washington as we push for a national jobs agenda and fight to protect our proven investment programs, and we need your help. Mayor Villaraigosa, the USCM Officers and I look forward to seeing in Washington next month. Attachment The United States Conference of Mayors Fall Leadership Meeting September 19 -21, 2011 The Fairfax at Embassy Row Washington, DC You may register on line at http /lusmayors.org/FallLeadershipl l or complete and fax this registration form to U.S. Conference of Mayors Meetings Department at (202) 467 -4276. (Any staff who accompanies a Mayor must complete a separate form.) Name Title Organization Address City State Zip Telephone Fax Email Name of Accompanying Spouse/Partner Attendee has special needs: Yes_ No (If yes, t15CM will contact) HOTEL INFORMATION A block of rooms has been set aside at the following hotel: The Fairfax at Embassy Row 2100 Massachusetts Avenue, NW Washington, DC 20008 (202) 293 -2100 Single/Double $285 Taxes: 14.5 IMPORTANT Room reservations must be made by calling the hotel directly at (888) 627 -8439. Please identify ,yourself as an attendee of The U.S. Conference of Mayors meeting to ensure receiving the group rate. Reservations must be confirmed with the hotel by Friday, August 26, 2011 Reservations must be guaranteed to a credit card for the first night's room deposit. Reservations must be cancelled 72 hours prior to arrival. Please return this form to: The U.S. Conference of Mayors Attention: Carol Edwards 1620 Eye Street, NW Washington, DC 20006 Telephone: (202)293 -7330 Fax: (202)467-4276 Kibbe, Sharon From: brainardjc @aol.com Sent: Tuesday, September 13, 2011 2:42 PM To: brainardjc @aol.com Cc: Martin, Candy; Kibbe, Sharon Subject: Itinerary Washington, DC Sep 20, 2011 (Itin# 138746752478) From: Name: James Brainard Email: brainardjc @aol.com This e -mail contains a copy of an Expedia itinerary sent by James C. Brainard (brainardjc@aol.com) from Elizabeth H. Brainard's account. TRAVELING WITH YOUR E- TICKET Airline check -in locations require a government issued photo ID and may request proof of current date travel (such as a printed copy of this itinerary or a printed receipt) to issue a boarding pass. Airport security checkpoints may require you to display both your boarding pass and photo ID before proceeding to the gate, so we recommend that you obtain your boarding pass before proceeding to the security checkpoint. FLIGHT SUMMARY Booked Expedia itinerary name: Washington, DC Expedia itinerary number: 138746752478 Expedia booking ID: GCQNTD (2) Airline ticket number(s): 0378678673237 US Airways confirmation code: EGRN7N The tracking number will be available by the end of the next business day. Round Trip Traveler: James Brainard Flight: from Indianapolis, IN (IND- Indianapolis Intl.) to Washington, DC (DCA- Ronald Reagan Washington National) Depart: Tue 20- Sep -11 at 6:00 AM Arrive: Tue 20- Sep -11 at 7:32 AM Depart: Indianapolis (IND), 20- Sep -11 at 6:00 AM Arrive: Washington (DCA), 20- Sep -11 at 7:32 AM Terminal: C Flight: US Airways 3442, operated by US AIRWAYS EXPRESS REPUBLIC AIRLINES Aircraft: EMBRAER 170 Meal Service: n/a Duration: 1hr 32mn Distance: 487 mi (784 km) Economy /Coach Class Seat: 09F Flight: from Washington, DC (DCA- Ronald Reagan Washington National) to Indianapolis, IN (IND- Indianapolis Intl.) Depart: Thu 22- Sep -11 at 6:30 PM Arrive: Thu 22- Sep -11 at 8:11 PM Depart: Washington (DCA), 22- Sep -11 at 6:30 PM Terminal: C Arrive: Indianapolis (IND), 22- Sep -11 at 8:11 PM Flight: US Airways 3431, operated by US AIRWAYS EXPRESS REPUBLIC AIRLINES Aircraft: EMBRAER 170 Meal Service: n/a Duration: lhr 41mn Distance: 487 mi (784 km) Economy /Coach Class Seat: 11F COST SUMMARY 1 adult: $240.00 Taxes Fees: $21.40 Total Cost: $261.40 2 Page 1 of l Transaction Date: OHM12011 Tue Transaction Deserlption: EXPEDIA INC ATLANTA GA US AIRWAYS, INC. i From: To Carries Class: iN01ANAPOLIS WASHINGTON NATIONA US K INDIANAPOLIS US S WA YY Do NIA YY 00 Ticket Numbec 03786785732374 Date of Departure: 09120 Passenger Name: BRAINARD /JAMES C Document Type: PASSENGER TICKET Cardmember Name: JAMES C BRAINARD i Amount 261.40 l i Doing Business As: US AIRWAYS ARC SALES i I Merchant Address: 4000 E. SKY HARBOR BLVD. PHOENIX AZ 85034 UNITED STATES Reference Number. 320112430162398181 Category: Travel -Airline https: online. americanexpress. com /myca/estmt/us /docs /print_doc. html 9/27/2011 Page 1 of 1 Transaction Dale: 09!23!2011 Fri Transaction Description: FAIRFAX EMBASSY ROW WASHINGTON DC 00510081202-293-2 Cardmember Name: JAMES C BRAINARD j Amount S: 697.81 Doing Business As: THE FAIRFAX EMBASSY ROW Merchant Address: 2100 MASSACHUSETTS AVE N WASHINGTON DC 20008 UNITED STATES Reference Number: 320112660439567618 Category: Travel Lodging https:// online.americanexpress.com/myca /estmt/us /docs /print_doc.html 9/27/2011 the fairfax at embassy row, washington d.c. 2100 massachusetts avenue north west Washington, district of columbia 20008 phone 202.293.2100 fax 202.293.0641 guest 518 travel agent /charge to James Brainard room 285.00 rate 1 12662 ROYCE CT no. pers. 598373 EX -A CARMEL, IN 46033 -2477 folio 1 page 20- SEP -1.1 07:47 arrive 22- SEP -11 USI19A depart payment 20- SEP -11 RT518 Room Grp Association 285.00 20- SEP -11 RT518 Room Tax 41.33 20- SEP -11 237A 877- 879 -1872 0007 15:28 ---2-49- RT518 Room Grp Association 285.00 21- SEP -11 RT518 Room Tax 41.33 21- SEP -11 553A 862 -0777 0007 15:13 -0$ 21- SEP -11 566A 877 879 -1872 0001 15:34 2. 0e 21- SEP -11 578A 877 879 -1872 0023 15:39 2..76 21- SEP -11 584A 659 -2229 0002 16:14 -2--p0 21- SEP -11 5184 Fairfax Lounge ---3�. Balance Due 69 .81 0. EXPENSE REPORT SUMMARY Date Room /Tax Food /Bev Telephone Other Total Payment 20- SEP -11 326.33 0.00 2.00 0.00 328.33 0.00 21- SEP -11 326.33 0.00 8.75 34.40 369.48 0.00 Total 652.66 0.00 10.75 34.40 697.81 0.00 Thank you for choosing Starwood Hotels. we look forward to welcoming you back soon! I agree to remain personally liable for the payment of this account if the corporation or other third party billed fails to pay part or all of these charges. signature James Brainard ROOM DEPART AGENT FOLIO 598373 20- SEP -11 518 VOUCHER NO. WARRANT NO. ALLOWED 20 Mayor Jim Brainard IN SUM OF One Civic Square Carmel, IN 46032 $1,163.06 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO# Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members 1160 Expense Report 43- 430.01 $54.00 1 hereby certify that the attached invoice(s), or 1160 Expense Report 43- 430.03 $914.06 bill(s) is (are) true and correct and that the 1160 Expense Report 43- 430.04 $195.00 materials or services itemized thereon for which charge is made were ordered and received except S},Inday, September 25, 2011 Mayor Title Cost distribution ledger classification if claim paid motor 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 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)) 09/22/11 Expense Report $54.00 09/22/11 Expense Report $914.06 09/22/11 Expense Report $195.00 1 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