177352 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 363329 Page 1 of 1
ONE CIVIC SQUARE KENT PAULIN
CARMEL, INDIANA 46032 C/O COMM CENTER CHECK AMOUNT: $321.51
CHECK NUMBER: 177352
CHECK DATE: 9/15/2009
DE ACCO UNT PO NU MBER INVOICE NU MBER AMOUNT DESCRIPTION
1115 4343002 REIMB 61.51 EXTERNAL TRAINING TRA
1115 4343004 REIMB 260.00 TRAVEL PER DIEMS
OF CA4,,
4TQKrres�pFl
CITY OF CARMEL Expense Report (required for all travel expenses)
EMPLOYEE NAME: /fie,✓ T U 1 1 DEPARTURE DATE: _9 O TIME: AM
DEPARTMENT: C C C RETURN DATE:_ O TIME: 0 0 AM/ IVR
REASON FOR TRAVEL: e 179D S G�j l� ®l DESTINATION CITY: 4 s VC,
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT L- PER DIEM
Transportation Gas Tolls/ Meals
Date Parkin Lodging Misc. Total
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
9/1/09 $65.00 $65.00
9/2/09 $31.51 $65.00 $96.51
9/3/09 1 1 $65.00 $65.00
9/4/09 $30.00 $65.00 $95.00
$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 $61.51 $0.00 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00
M
DIRECTOR'S STATEMENT: I h that all ex {i nses H e 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 9/6/2009 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 expendi res) being deduct from the first paycheck issued more than 30 days after the date of my return.
Employee Si nature: Date: lb
City of Carmel Form ER06 Revision Date 9/6/2009 Page 2
RE: Courtyard Chicago Arlington Heights /South Reservation Confirmation #87292046 Page 1 of 5
Arnone, Janet R
From: Collins, Mindy L
Sent: Tuesday, July 21, 2009 12:05 PM
To: Arnone, Janet R; Heinzman, Mike D
Subject: RE: Courtyard Chicago Arlington Heights /South Reservation Confirmation #87292046
Detail for Course 15307 Back
Start Date: 09/02/2009 A l e gt kz7
End Date: 09/04/2009
Start Time: 8:00 AM
End Time: 5:00 PM
Site: AMR of Grand Rapids
Location: Grand Rapids, MI
517 South Division
Address: Grand Rapids, MI 49503
Register for this course!
0
From: Arnone, Janet R
Sent: Tue 7/21/2009 7:02 AM
To: Heinzman, Mike D; Collins, Mindy L
Subject: RE: Courtyard Chicago Arlington Heights /South Reservation Confirmation #87292046
Do you have anything from EMD that proves there is a class on these dates? The Clerk's office will need something.
Janet R. Arnone
Office Administrator
Carmel Clay Communications Center
31 1st Avenue N.W.
Carmel, Indiana 46032
(317) 571 -2586
Original Message----
From: Heinzman, Mike D
Sent: Monday, July 20, 2009 5:08 PM
To: Arnone, Janet R; Collins, Mindy L
7/21/2009
Co Courtyard by Marriott Grand Rapids,mi 49503
Grand Rapids Downtown T 616.242.6000
�affl0n
'sat NFL
,:Kent Paulin Room: 417
�i31 1st Ave Nw ,Room Type: GENR!
a 'Carmel IN 46032' Number.of Guests:1 x
Cdy Of Carmel Indiana Rate: $84;00 Clerk: BKH.'
Arnve {31 �e�09`�' Ttme't34 22PM�, depart 04SepQ9 ��Tirrte 47 33AM >�ota Number✓ 94776
11Aug09 Advance Deposit 287.28
01 Sep09 Room Charge 84.00
01 Sep09 Room Tax /Assessment 11.76
01 Sep09 Daily Parking 11.00
02Sep09 Restaurant Room Charge 12.55
02Sep09 Room Charge 84.00
02Sep09 Room Tax /Assessment 11.76
02Sep09 Daily Parking 11.00
03Sep09 Room Charge 84.00
03Sep09 Room Tax /Assessment 11.76
03Sep09 Daily Parking 11.00
04Sep09 Rebate Parking 33.00
04Sep09 Master Card 12.55
Card MCXXXXXXXXXXXX78781XXXX
Amount: 12.55 Auth: 07149P Signature on File
This card was electronically swiped on 01 Sep09
Balance: 0.00
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As requested, a final copy of your bill will be emailed to you at: MHEINZMAN @CARMEL.IN.GOV. See "Internet Privacy
Statement" on Marriott.com.
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))
09/08/09 $260.00
09/08/09 $61.51
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
VOUCHER NO. WARRANT NO.
Kent Paulin ALLOWED 20
IN SUM OF
1300 Woodpond Roundabo t
Carmel, In 46033
$321.51
i
a
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1115 43- 430.04 $260.00 1 hereby certify that the attached invoice(s), or
1115 43 430.02 $61.51
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, September 10, 2009
Direc
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund