HomeMy WebLinkAbout168926 02/17/2009 F CITY OF CARMEL, INDIANA VENDOR: 00352429 Page 1 of 1
ONE CIVIC SQUARE MINDY COLLINS
CARMEL, INDIANA 46032 cio ccCC CHECK AMOUNT: $275.15
c /O cccC CHECK NUMBER: 168926
CHECK DATE: 2/17/2009
DEPARTMENT AC COUNT PO NUMBER IN VOICE NUM BER A DESCRIPTION
1115 4343002 125.00 EXTERNAL TRAINING TRA
1115 4343004 150.15 TRAVEL PER DIEMS
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CITY OF CARMEL Expense Report (required for all travel expenses)
Mindy Collins 2/9/2009 TIME: AM rP M
Carmel Clay Communications Center 2/11/2009 TIME: 01 J� AM M
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EMD -O Training Lawrenceburg,IN
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
2/9/09 $25.00 $25.00
2/10/09 $50.00 $50.00
2/11/09 $50.001 $50.00
$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
0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $125.00 $0.00 1
DIRECTOR'S STATEMENT: I In that all ex p nses 1 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 2/13/2009 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 expenditures) bei ucted from the first paycheck issued more than 30 days after the date of my return.
Employee Signature: Date: In
City of Carmel Form ER06 Revision Date 2/13/2009 Page 2
Priority Dispatch Register your course! rage t 01 j
Choose by Discipline: 1s
s 'international
Upcoming Courses EAAD EFD EPD ETC Province State
Course Registration Form
Please complete the following to register for a course. One form per registrant please.
If you wish, you can print this form and fax it to 801 363 -9144.
Contact Information
Name: Your Agency:
Title: Email:
Work Phone: I Ext. F77 Home Phone: I
Fax:
Agency Addr 1: Addr 2:
City: County:
State /Province: Zip /Postal Code: r
Country: F
Required to register for course.
Course Information
Course 15467
F AM
Type: EMD Quality Assurance F
Course Into Location: Lawrenceburg, IN
Start Date: 02110/2009
End Date: 02/11/2009
"STOPI' if the above Is not the course you want to register for please, return to courses.
Q $550 USD ON -TIME REGISTRATION
Course Fee 1 WOO LATE REGISTRATION
Register today to avoid any additional fees for registrations within 10 days of the start date.
h4s:// www. xmission .com/— prioritydispatch/courses/ courseregistration .php course_id =10314 1/7/2009
BY STATE HOARD OF ACCOUNTS
Gr:7"aRAL FORM NO. 101 (1986)
MILEAGE CLAIM
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(GO ON ACCOUNT OF APPROPRIATION NO. 7 FOR
(OFFICE, BOARD, DE'AniMzNT OR INS ,,CM
FROM TO
SPEEDOMETER AUTO GE
ATE I READING MIT
NATURE OF BUSINESS MILES Q c
POINT POINT START i FINISH TRAVELED_ PER MILE
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AUTO LICENSE NO. TOTALS
DOMETFR READING cclumns are to be used only when distance between pcints cannot be determined by fixed mileage or official 1 ighway map.
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Pursuant to the provisions and penalties of Chapter 155, Acts 1 953, I hereby certify that the foregoing account it' just and correct, that the amount claimed is legally d, after allowing all just credits
that.no part of the same has been paid_
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I c(Jrfity that the within Of is true an;I correct; that the mileage therein ilewizcrl
and for which charge is We was ordered By ure and was necessary (o th(J IndAic
m (i w N Business; and drat UM rate per mile is in accordance with statutes or governing
J tJ ordinances except
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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))
02/13/09 $125.00
02/13/09 $150.15
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
VOUCHE NO. WARRANT NO.
ALLOWED 20
Mindy Collins
IN SUM OF
11429 Pegasus Drive
Noblesville, IN 46060
$275.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 43- 430.02 $125.00 1 hereby certify that the attached invoice(s), or
1115 43- 430.04 $150.15
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
Friday, February 13, 2009
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund