HomeMy WebLinkAbout203540 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 364896 Page 1 of 1
ONE CIVIC SQUARE BLAINE MALLABER
CHECK AMOUNT: $366.50
CARMEL, INDIANA 46032 19571 LANDRUM CIRCLE
NOBLESVILLE IN 46062 CHECK NUMBER: 203540
CHECK DATE: 11/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 366.50 EMPLOYEE PENSIONS B
CITY OF CARMEL Expense Report (required for all travel expenses)
r N�
�o� a reimbursement rate is 50 cents /mile
w... 2010 mileage
pLOYEE NAME:
B llaber 10/17/2011 TIME: 1:00 pm
laine Ma
EM ErIT: Utilities /Sewer 10/19/2011 TIME: 8:00 pm
pEpARTM DESTINATION CITY: Findlay, Ohio
TRAVEL: Confined Space Training
REASON FpR
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM
Transportation Gas/Tolls/ Lodging Meals Misc. Total
pate /fir -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$32.50 $32.50
,011711 $65.00 $65.00
10/181 $65.00 $65.00
r X0119/1
$45.00 $45.00
10/19/11 $159.00 $159.00
x 10/19/11
$0.00
r $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
Total $0.00 $0.00 $0.001 5.00 $159-001 $0.001 $0.00 $0.00 $0.00 $162.501 $0.00 e
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:
spa
City of Carmel Form ER06 Revision Date 10/20/2011 Page 1
r k
i
109 10 -20 -11
Folio No. 75484 Room o. 211
A!R Number Arrival 10 -17 -11
Group Code Depart a 10 -19 -11
Blaine Mallaber Company UNIVERSITY OF FINDLAY Cont N 3. 66886755
IVIembership No.: Rate Code ILCORUOF
Invoice No. Page N). 1 of 1
Date Description Cha eg Cuts
10 -17 -11 *Accommodation 75.00
10 -17 -11 City Tax Room 4
10 -18-11 'Accommodation 75.00
10 -18 -11 City Tax Room 4.50
10 -19-11 Visa XXXXXXXXXXXX5959 159.00
Total 159-00 159.00
Balance 0.00
Guest Signature:
I have received the goods and 1 or services In the amount shown heron. I agree that my Mablity for this all is not waived and agree to I a held
personally liable in the event that the it kvted Person, company, or associate tails to pay for any Part or the ruM anwunt of these Char es. if
a credit card charge, I further agree to perform the obligations set forth In the cardholder's agreement with the issuer.
M�.
S111teS
Tess N�te1 p
Inn Exp 4
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4
FINDIAY
THE UNIVERSITY OF FINDLAY
0 0 Achl"evement
awarded by
THE ALL HAZARDS TRAINING CENTER
to
Blaine lallaber
for Successful Completion of
CONFINED SPACE ENTRANTIATTENDANTISUPERVISOR TRAINING WORKSHOP
(FULFILLS THE REQUIREMENTS OF 29 CFR 1910.146)
8 HOURS OF TRAINING
OCTOBER 18, 2011
J
EXECUTIVE DIRECTOR INSTRUCTOR
FINDIAY
THE UNIVERSITY OF FINDLAY
C ertific a te of Ac
awarded by
THE ALL HAZARDS TRAIN
to
Blaine Mallaber
for Successful Completion of
CONFINED SPACE ENTRY BASIC RESCUE WORKSHOP
(IN ACCORDANCE WITH 29 CFR 1910.146)
8 HOURS OF TRAINING
OCTOBER 19, 2011 4)
T O-
r it
EXECUTIVE DIRECTOR INSTRUCTOR
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
T1998
MALLABER, BLAINE Purchase Order No.
CARMEL WASTEWATER Terms
Due Date 11/1/2011
Invoice. Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/1/2011 101711 $366.50
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with. IC 5- 11- 10 -1.6
Date O ice
VOUCHER 116102 WARRANT ALLOWED
T1998 IN SUM OF
MALLABER, BLAINE
CARMEL WASTEWATER
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
101711 01- 7042 -06 $366.50
Voucher Total $366.50
Cost distribution ledger classification if
claim paid under vehicle highway fund