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Home My WebLink About204742 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: T358497 Page 1 of 1 ONE CIVIC SQUARE DARCY CASE CHECK AMOUNT: $114.06 CARMEL, INDIANA 46032 13154 DUNW000Y LANE CARMEL IN 46033 CHECK NUMBER: 204742 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4343004 114.06 TRAVEL PER DIEMS '�prFre [ry CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: _Darcy Case DEPARTURE DATE: 12/12/2011 TIME: 8:30 AM l PM DEPARTMENT: Communications RETURN DATE: 12/14/2011 TIME: 16:00 AM/PM REASON FOR TRAVEL: CTO School DESTINATION CITY: idianapolis EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem 12/12/11 $20.00 $20.00 12/13/11 $15.00 $15.00 12/14/11 $1$.00 $18.00 $0.00 $0.00 10.00 $0.00 $0:00 $o.00 $0.00 $0.00 Moo .$0.00 $0.00 $0:00 $O:oo $0.00 $0:00 $0.00 $.0.00 0.00 Total $0.00 $000 $0.00 $0.00 $0.00 $0.00 $53:00 $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 9 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: 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 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 e e )ditures) bein ucted from the first paycheck issued more than 30 days after the date of my return. i Employee Signature: Date: City of Carmel Form ER06 Revision Date 12/15/2011 Page 2 Prescribed by Sate Beard cf Ac counts Gene- Form No. ;p; {955) MILEAGE CLAIM l— TO C��-- d�-e -t DR. eby-1 n- (An (Governmental Unit) J On Account of Appropriation No. 41�. r for (Uff ioe, Board. Department or Institution) DATE FROM TO ODOMETER READING* NATURE OF BUSINESS ii AUTG MILES MILEAGE 20 Point Point Start Finish TRAVELED PER MILE I S� o o n ►I z' II �d I, j I u 11 I I II I 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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is 1 ally ue, after allowing all Just credits, and that no part of the same has been paid. i Date 1. Claim No. Warrcuit No. I have examined the within claim and hereby certify as follows: IN FAVOR OF Thcrt it is in propel form; That it is duly authenticated as Iequired by law; That it is based upon statutory authority; That correct t it is apparently incorrect On Account of Appropriation No. for Disbursing Officer (D Allowed 20 o R 0 •C in the sum of p- cn tD i¢@ in CD m CD m M—d o� F� CD 2--r 0 N P. m c�u m m CD 5 (Official Title) CD O C CD Vivian, I have to pay 14% shipping since the class is less than 21 days out? From: Nowaczewski, Vivian K rmai Ito: ViNowaczewski(,d)i sp c.IN,aov] 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 /REDDICK have attached a copy of the order form. Use my name as the instructor's name. Order the CTO 4 Edition. After October APCO will be going to the Stn 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. 44Vhm -NVWa ws k 7'r7Titti 0it'ert'or- .NAS- Coordinator-, IUgated�l?u$Lic }y,�Commission 8500 East 21st Street Indianapolis, IN 46219 yinowaczewslftsc.I24 oy Office 317 -899 -8534 Cell 317- 447 -7686 Fox 317 899 -8282 From: Heinzman, Mike D mailto :MHeinzmanCacarmel.in.gov] Sent: Tuesday, August 23, 20112:58 AM To: Nowaczewski, Vivian K; Akers, William P; Jokantas, John M Cc: Arnone, Janet R Subject: CTO TRAINING COURSE (APCO IPSC) 9.13.11 9.15.11 /POLOVICK /CASE /REDDICK Sept ber`1 =15° Communications -Train rigOfficers IPSTUTrain ng— Train eTr nia er �O 1 G- ourse --G.enterb, Course 85_00 ]E--- 21st St. Indianapolis,; TN 16219 PROPOSED ATTENDEES: Tfara= Po .I.oyick,.Da%3L-Case-,-Josh'RFd aibk 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 I— I'" s c CTO December 12th -14th 2011 NAME AGENCY SIGNATURE Josh Reddick Carmel PD Darcy Case Carmel PD Tara Polovick Carmel PD Cathie Austin Fountain- Warren County, Susan Baugher Porter County Jessica Neff Noblesville ;Z �Ir �y` Nick Tucker Noblesville Becky Feltz Hamilton County A Brenda King Hamilton County 7, u.A Gina Sok er ieclt- Hamilton County James Miller Hamilton County Sharon Decker Hamilton County Melissa SiM Hamilton County Karen Stafford Hendricks County Andrea Baughn Hendricks County Leslye Harrell Hendricks County Darin Riney Wayne County, Tina Lantz Indianapolis Airport Maf#k Mj�aT' NfagseW Indianapolis Airport Patricia Oros Lake County JvC Kara Ralowski Lake County E Lloyd McCracken Capitol Police Leesa Slover ISP Region III L Q,eQQL Utll fly St6vens ISP Region IQ,�i Kv If, H0-II is RM 11D Y) VOUCHER NO. WARRANT NO. ALLOWED 20 Darcy Case IN SUM OF 13154 Dunwoody Lane Carmel, In 46033 $114.06 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. I ACCT #rrITLE AMOUNT Board Members 43- 430.04 $114.06 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 Thursday, December 15, 2011 Director 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)) 12/15/11 $114.06 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