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Home My WebLink About204933 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 359024 Page 1 of 1 ONE CIVIC SQUARE TARA POLOVICK CARMEL, INDIANA 46032 14418 SIMPLICITY PKWY APT 3D CHECK AMOUNT: $143.73 CARMEL IN 46033 CHECK NUMBER: 204933 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION 1115 4343002 70.91 EXTERNAL TRAINING TRA 1115 4343004 72.82 TRAVEL PER DIEMS i Prescribed by State Board of Accounts J' General Form. No. (1 955) ��1, II MILEAGE CLAH 11� YVI�.� l� o w11M u vl 1 OVA To C� CI L,lQSS 1 �1� Y S SR 5 DR. (Governmental Unit) QYYk —M—kA— YAUAinY1S I On Account of Appropriation No. 4%�D O for Uffice, Board, Departme 'rt or Institution} DATE FROM I TO ODOMETER READING' NATURE OF BUSINESS I Au?'O MILES MILEAGE �.S 20 Point 1 Point Start I j Finish RAVELED PER MILE C 13 SLIM \i N IN 1 o unwc*;± In GWTP, &I IM 3.1c 1 CTu M55 j2 1 u 15 4 otol 11119 kA 1 00 G 11"- yal Q'T0 O-S S t l l I I I 85� E sl nd�4•.4 i 1^ �I� Pmt VA \ndi Lm�k,s •O Z. 0 C�1 �n s S 1 Z o y-A IZd Irk -"A wo. t_r\ X3.0 I 41 airs d l •4 114 L l 45. 3.cp I 5 144113 S V1 Cx Cram-Lk 81C, t SouAW Servt4 VA 1 li O• C� O i s Z, o v 1 OUA 14 A& U iNw o� 1 Li q 1 9) WL o 2 yy 2 i I I I I i li II II I I Auto License No. TOTAIS I I SPEEDOMETER READING columns are to be usei 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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due; after allowing all just credits, and that no part of the same as been paid. Date Q uhi �tr I `I Clcum No. Warrant No. I have examined the within claim and hereby certify as follows: IN FAVOR OF That it is in proper form; That it is duly authenticated as required by law; That it is based upon statutory authority; That it is apparently correct incorrect On Account of Appropriation No. for Disbursing Officer o o Allowed 20 0 o in the sum of o M 0M mo S rr x� b D M M N o M a (Bowd or Commission) Fay Cr EP CD cam (Official Title) CD O M Course Name: Operator Refresher Course Class: December 15, 20118:30 AM Class Location: Indianapolis Airport PD AOC /EOC 8101 S SERVICE RD INDIANAPOLIS, IN 46241 Class was Completed: December 19, 2011 Student Name ORI Completed GILBERT, AMANDA INO32011N fv JOSEPH, LORI IN0490600 Fv LAIRMORE, MICHELLE INO32011N W POLOVICK, TARA INO29011N W SANDERS, TIFFANY IN0490600 Fv TATMAN, CHAD INO32011N fo WILSON, BRAD IN0550100 I✓ WYLER, KAY INO29011N °qtr OF CA9�F! �Qn R CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: Tara Polovick DEPARTURE DATE: December 12, 2011 TIME: 730 AM DEPARTMENT: Communications RETURN DATE: December 14, 2011 TIME: 500 PM REASON FOR TRAVEL: CTO School DESTINATION CITY: Indianapolis 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 12/12/11 $22.87 $2277 12/13/11 $20.67 $20.67 12/14/11 $27.371 $27.37 $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 Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $70.91 $0.00 $0.00 $0.00 $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 12/15/2011 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 $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: 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 I 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: Tara Polovick (electronic signature) Date: December 15, 2011 City of Carmel Form ERO6 Revision Date 12/15/2011 Page 2 Vivian, I have to pay 14% shipping since the class is less than 21 days out? From: Nowaczewski, Vivian K fmailto :ViNowaczewski(a)ipsc.IN.gov1 Sent: Tuesday, August 23, 20118:03 AM To: Heinzman, Mike D; Akers, William P; Jokantas, John M Cc: Arnone, Janet R Subject: RE: CTO TRAINING COURSE (APCO IPSC) 9.13.11 9.15.11 /POLOVICK /CASE RED DICK I have attached a copy of the order form. Use my name as the instructor's name. Order the CTO 4th Edition. After October APCO will be going to the 5th Edition. I had a CTO class schedule in November However due to a scheduling conflict it has been cancelled. I will announce an alternative later. I have everyone registered as requested. Please contact me if you have any other questions. Vivian Nowaczewski Training Director Ns'1'WAseoordinator. IntegraterlPub(icSafet, s 7ommi5sion 8500 East 21st Street Indianapolis, IN 46219 yinowaczewski@i psc. I 2�go_y Office 317 899 -8534 Cell 317 447 -7686 Fax 317 899 -8282 From: Heinzman, Mike D mailto :MHeinzmanO)carmel.in.Qov], Sent: Tuesday, August 23, 20112:58 AM To: Nowaczewski, Vivian K; Akers, William P; Jokantas, John M Cc: Arnone, Janet R oa Subject: CTCT RAINING COURSE (APCO /`IPSC 9 :13.11 915:1- 1 /POLOVICK /CASE %REDDICK CSep er 1Y3 15; c-- Corrimunication Training Officers. CEIi'SC "Train rig" Tra nathe Trainees G2`Q?1 -1 jt Lap cGoursegmop �Cente CCo rse= E &5,QQW72= 13st,Stq Glndianap�olis;�IN 46219 PROPOSED ATTENDEES: C Tara> Rd lov `ck: ,,DarcykCase,,J.6th Cost of class: Free Cost of APCO CTO book X 3 (required) Unknown Vivian, can you advise how to order this book (can't find on APCO website) and please register us to attend? John, I just noticed I will be out of town during most of the above class (Sept 14 18), 1 will go later if possible. 2 J— P S C CTO December 12th 14th, 2011 NAME AGENCY SIGNATURE Josh Reddick Carmel PD Darcy Case Carmel PD Tara Polovick Carmel PD U Cathie Austin Fountain Warren County Susan Baugher Porter County Jessica Neff Noblesville Nick Tucker Noblesville Becky Feltz Hamilton County Brenda King Hamilton County G Gina SsW@*ecir- Hamilton County James Miller Hamilton County Sharon Decker Hamilton County Melissa•BiM Hamilton County Karen Stafford Hendricks County Andrea Baughn Hendricks County Leslye Harrell Hendricks County Darin Riney Wayne County_ Tina Lantz Indianapolis Airport NON"eU -Payne Indianapolis Airport Patricia Oros Lake County Kara Ralowski Lake County ;r Lloyd McCracken Capitol Police Leesa Slover ISP Region III LMA 1 9 Racy StLsvens ISP Region I 1 Half ISM' Peg' tiK) II 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)) 12/16/11 $70.91 12/16/11 $72.82 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 1 20 Clerk- Treasurer VOUCHER N WARRA NO. ALLOWED 20 Tara Polovick IN SUM OF 13154 Dunwoody Lane Carmel, In 46033 $143.73 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1115 43- 430.02 $70.9 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1115 43- 430.04 $72.82 materials or services itemized thereon for which charge is made were ordered and received except Friday, December 16, 2011 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund