176704 09/02/2009 CITY OF CARMEL INDIANA VENDOR: 360070 Page 1 of 1
3 ONE CIVIC SQUARE JUN CHEN
CARMEL, INDIANA 46032 3973 DOLAN WAY CHECK AMOUNT: $360.00
r.oa
WESTFiELD IN 46074 CHECK NUMBER: 176704
CHECK DATE: 9/2/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1202 4343002 T REIMB 360.00 EXTERNAL TRAINING TRA
ty of C4 R,y\ r
CITY OF CARM'EL Expense Report (required for all travel expenses)
/NOIANa
P
EMPLOYEE NAME: Jun Chen DEPARTURE DATE: 8/16/2009 TIME: 11:00 AM
DEPARTMENT: Is RETURN DATE: 21 -Aug TIME: 8:30 PM
REASON FOR TRAVEL: Training DESTINATION CITY: Detroit
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT PER DIEM
Transportation Gas /Tolls/ Meals
Date Lodging Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
8/16/09 $60.00 $60:00
8117109 $60.00 $60:00
8/18109 $60.00 $60.00
8119/09 $60.00 $60:00
8/20/09 $60.00 $60:00
8121109 $60.00 $60`:00
$0` 0.0
$0 ".00
$0.00
$0.00
$0:00
$o;
$0:00
$0.00
$0:00
$0.00
$0 00
$0:00
$0:00
$0 3 00
000
Total $0.00 $0.00 $0,.00 $0 $0.00 $0.00 $0:00. $fl.0,0 $0.00 $360:00 $0.00 �$.$360:00
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: t f.
City of Carmel Form ER06 Revision Date 8/24/2009 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) being deducted from the first paycheck issued more than 30 days after the date of my return.
Employee Signature: Date:
City of Carmel Form ER06 Revision Date 8/24/2009 Page 2
a
Rebecca Chike FR, No 367
3 Civic Square arrival 08- 1 16 -09
Carmel, IN 45032 Departure 08 -21 -09
us Page No. 'I of 3
Folio No. 310665
INVOICE Cont. No 283928
Membership No. Cashier No 12
AIR Number Invoice No. I
Group Code
Company Name 08 -21 -09
Date Text Charges Credits
08 -16 -09 Check 1,062 16
08 -16 -09 Room Routed From Chen J Of Rr =3 97.00
05 -16 -09 State Tax 6 Routed From Cnc -rl Jul, Of Room =359 5.c 2
08 -16 -09 Occupancy Tax 2 Routed From Cnen Jain Oi Room =:359 1 94
08 Local Tax 1.5% Routed From t.neri Jun Of Rc X359 1.46
08 -16 -09 Room 97.00
08 -16 -09 State Tax (3 5.82
08 -16 -09 Jccupancy Tax 2`% 1.94
L Ta= i 1. fl3
08 -17 -09 Roorn Routed Fron ;✓glen Jun Uf Room ,7359 97.00
08 -17 -09 State Tax 6 Routed Frorn Chen Jun 01 Room #359 5.82
08 -17 -09 Occupancy Tax Routed From Cher, Jun Of Room #359 1 .94
08 -17 -09 Loral Tax 1.5 /r Routed From brier) Jun Of Rory %n I X359 1 46
08- 17 -09 Room 97 ;_IO
08 -17 -09 State Tax 6 5.62
OB -17 -09 Occupancy Tax 2�/, 1.94
08 -17 -09 Local Tax 1.5 1 46
08.18 -09 Room Routed From Cheri Jun Of Roorn #359 97.00
08 -13 -09 State Tax 6%,, Routed Frorn Chen J�_ €n 31 Roorn K359 5.82
08-118-09 Occupancy Tax 244, Routed Fro €u Chen Jun Of Room ,_"359 1.94
08- '15 -09 Local Tax 'I .5%C Routed ll Chen Jun Of Room X359 1.46
08-18 -09 Roorn 97.00
08 -18 -09 State Tax f3' 5.82
agree, ;ha; my Iiebili., irr.hic Lill i�- no r:"a,veti and ntrree be I 'l!a ,�;ri;�ll,, :e" uivll'I 11 J'01: hr' uerson _ra,�� gym; or
lailg uav rur af"y n r car or one lull "I[" OU1111 c! o: llry
Guest Signature
FFa:1iEScir Ho:el Detrr,c e Hills
39475 WuoOv;aw Ave.
Bloo; wield HIVE. f'.1141"J04
Telephone
email; rt;l blrni;t ?�radisson.r.on,
1j T
Rebecca Chike Room No. 367
3 Civic Square Arrival 08 -16 -09
Carmel, IN 46032 Departure
08-21-09
US Page No. 2 of 3
Folio No. 310665
INVOICE Conf, No. 283928
Membership No. Cashier No. 12
AIR Number
Invoice No. J
Group Code
Company Name 03 -21 -09
Date Text Charges Credits
08 -18 -09 Occupancy Tax 2% 1,94
08 -18 -09 Local Tax 1,5% 1.46
08 -19 -09 Room Routed From Chen Jun Of Room #359 97.00
08 -19 -09 State Tax 6% Routed From Chen Jun Of Room #359 5.82
08 -19 -09 Occupancy Tax 2% Routed From Chen Jun Of Room #359 1.94
08 -19 -09 Local Tax 1.5% Routed From Chen Jun Of Room ='359 1.46
08 -19 -09 Room 97.00
08 -19 -09 State Tax 6% x.82
08 -19 -09 Occupancy Tax 2 °'0 1.94
08 -19 -09 Local Tax 1.5% 1.46
08 -20 -09 Room Routed From Chen Jun Of Room #359 97.00
08 -20 -09 State Tax 6% Routed From Chen Jun Of Room =359 5.82
08 -20 -09 Occupancy Tax 2% Routed From Chen Jun Of Room =359 1.94
08 -20 -09 Locale Tax 1.5% Routed From Chen Jun Of Room =359 1.46
08 -20 -09 Room 97.00
08 -20 -09 State Tax 6% 5.82
08 -20 -09 Occupancy Tax 2% 1.94
08 -20 -09 Local Tax 1.5% 1.46
08 -21 -09 Cash ;x 04
Total 1.062.20 1,062.20
Balance 0.00
I agree ha*, my Iiabili:v for '.his bill is no: waived and agree :o be held per onaliv respons€ble in :he oven. :ha::he indica:ea person. ccmr3ny or assoc €a: €cn
tads :o pay for any portion or :he full amount of .hese marges
Guest Signature
Rad€sson Hotel De;roc 31ccmfield €Ils
39475 4V(;Oo and Ave.
Bloomfield Hills, +Mi 48 04
Telephone: 1245) 644 -1400 Fax: (248) 6 44 -5-149
Emad: mi_L•Imitn radisson ccn€
Prescrided 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
J Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/16/091 Per Diem for travel to Detroit
Total
I 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 0 /31 /09 WARRANT NO.
ALLOWED 20
IN SUM OF
$360.00
ON ACCOUI� N FOR
1202 Information Systems
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1202 430 02 $360.00 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
20
Signat e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund