175716 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1
ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $2,558.81
CARMEL, INDIANA 46032 ciO DEPT OF LAW
o� C 0 DEPT OF LAW CHECK NUMBER: 175716
CHECK DATE: 8/6/2009
DEPA RTMEN T ACC OUNT PO NUMBER INVOICE NU MBER AMOUNT D ESCRIPTION
1180 4343002 REIMB 2,487.86 EXTERNAL TRAINING TRA
1180 4343004 REIMB 70.95 TRAVEL PER DIEMS
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) �3 O
ON ACCOUNT OF APPROPRIATION NO. 00 FOR
AQW11-1 ad
(OFF ICE, BOARD,DEPA NT OR INSTITUTION)
SPEEDOMETER A UTO MILEAGE
DATE p FROM TO READING NATURE OF BUSINESS MILES
'fig �Cz[� 1 POINT POINT START FINISH TRAVELED PER MILE
n� o 5 a7/5
b
CT 6111
a.5 y 5
to 4 ql
3 �:rm 1 -6 s
da- I OCiA WJ A 1 3 (a Ag' 0 0
AUTO LICENSE NO. TOTALS 170
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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no art of the same has been paid.
Date a
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
C 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
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Disbursing' Officer
On Account of Appropriation Noy- ac for
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A.E. BOYCE CO., INC. MUNCIE; IN 01136
100 Sandoval Street Santa Fe, NM 87501
Phone (505) 988 -2811 Fax(505)986-6435
Reservations
Name Address Santa Fe www.hiltonofsantafe.com or 1 800 HILTONS
HANEY, DOUGLAS Room 204/D2
13828 SMOKEY RIDGE DR Arrival Date 7/22/2009 3:23:OOPM
Departure Date 7/26/2009
CARMEL, IN 460339101 Adult/Child 2/2
US Room Rate 239.00
RATE PLAN L -DJ
HH# 864254159 DIAMOND
AL NW #061240012
BONUS AL CAR
Confirmation Number: 3328861058
7/26/2009 PAGE 1
DATE DESCRIPTION I ID REF. NO CHARGES CREDITS BALANCE
7/22/2009 GUEST ROOM SEH 1055665 $239.00
7/22/2009 CITY LODGERS TAX SEH 1055665 $16.73
7/22/2009 GROSS RECEIPTS SALES SEH 1055665 $19.27
TAX
7/23/2009 GUEST ROOM SRM 1056241 $239.00
7/23/2009 CITY LODGERS TAX SRM 1056241 $16.73
7/23/2009 GROSS RECEIPTS SALES SRM 1056241 $19.27
TAX
7/24/2009 GUEST ROOM SRM 1056906 $239.00
7/24/2009 CITY LODGERS TAX SRM 1056906 $16.73
7/24/2009 GROSS RECEIPTS SALES SRM 1056906 $19.27
TAX
7/25/2009 GUEST ROOM SRM 1057543 $239.00
7/25/2009 CITY LODGERS TAX SRM 1057543 $16.73
7/25/2009 GROSS RECEIPTS SALES SRM 1057543 $19.27
TAX
WILL BE SETTLED TO $1,100.00
EFFECTIVE BALANCE OF $0.00
Hilton HHonors(R) stays ar posted within 72 hours of checkout. To ch6 ck
your earnings for this or aI 7y other stay at more thar 3, 000 Hilton Family
hotels worldwide, please g isit HiltonHHo iors.com.
DATE OF CHARGE FOLIO NO. /CHECK NO. 7%7
162296 A
Zip -Out Check -Out' JL
Good Morning! We hope you enjoyed your stay. With Zip -Out Check -Out® AUTHORIZATION INITIAL
there is no need to stop at the Front Desk to check out.
Please review this statement. It is a record of your charges as of late last PURCHASES SERVICES If
evening.
For any charges after your account was prepared, you may:
TAXES ki
pay at the time of purchase.
charge purchases to your account, then stop by the Front Desk for an
updated statement. TIPS MISC.
or request an updated statement be mailed to you within two business days.
Simply call the Front Desk from your room and tell us when you are ready to
TOTAL AMOUNT
depart. Your account will be automatically checked out and you may use this
statement as your receipt. Feel free to leave your key(s) in the room.
Please call the Front Desk if you wish to extend your stay or if you have any
questions about your account.
ALI -ABA WEB REGISTRATION /ORDER FORM
download this for
If you do not wish to register or order online, you may print out and complete this form, then send it with payment to:
ALI -ABA Customer Service Dept., 4025 Chestnut Street, Philadelphia, PA 19104 -3099. Orders charged to credit
cards may be faxed to (215) 243 -1664 or telephoned to (800) CLE -NEWS (253 -6397) or (215) 243 -1600.
Please register me for the Course of Study (title:) Developments In Employment Law
Course No. CRO 1 n Date(s) .T„ 1 )z 21-2 5 09 Tuition 9 36 7 5
Please register me for the Video Law Review Program (title:)
I plan to attend Viewing Site No. City State Program No. VF Tuition
I plan to view the live webcast on my office or home computer. Program No. VC Tuition
Webcast FAQs https: www.ali aba.org /webcast/fag.asp Webcast Test Page hftps://www.aii-aba.orgANebcast/tp-st.as
ALI -ABA must receive registrations for live webcasts no later than 5 p.m. Eastern Time one business day before the program.
If two or more will view the program at one computer, arrange for group viewing through Ruth Johnson (riohnsone- ali -aba org
215- 243 -1601, fax 215- 243 1608). A tuition discount is available for group viewings of the live webcast.
Please enter my order for the following products (e.g.: books, tapes, course materials):
Qty. Order Code Title Price Total
Subtotal
Tax*
Tuition
TOTAL
DOUGLAS C. HANEY
Name
Gity of Carmel, Indiana
Firm
One C.ivir Square
Street address (No P.O. boxes for orders or webcast registrations.)
Carmel sndiana 46032
City State Zip +4
(317) 571 -2472 (317) 571 -2484
Telephone Fax E -mail
Purchase Order No. 19169
Payment must accompany orders. heelfmade payable to ALI -ABA enclosed.
AMEX DISCOVER MasterCard VISA
Card No. Exp. Date Signature
Pa. residents ONLY add 7% sales tax, excluding registrations and subscriptions.
NOTE: No credit allowed for returned publications unless prior authorization to return is requested within 30 days of receipt
of materials. Cassettes and discs are not returnable, but will be replaced if defective.
My office is a member of ALI -ABA In- House. Payment is in the amount of the stated tuition or price, less 15
Ha w did you learn of the above courses and products? Check all that apply:
E -mail promotion Web search Printed promotion Colleague
Advertisement of related product Other:
Promotion Code A560
V QpFT.fK4 "AF�
CITY OF CARMEL Expense Report (required for all travel expenses)
NOIANp
EMPLOYEE NAME: Douglas C. Haney DEPARTURE DATE: 07/22/09 TIME: 7:15 A.M.
DEPARTMENT: Law Department RETURN DATE: 07/26/09 TIME: 2:05 P.M.
REASON FOR TRAVEL: ALI -ABA Seminar DESTINATION CITY: Santa Fe, New Mexico
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
$0.00
July 22 26,
2009 1 $519.50 $443.36 $100.00 $1,100.00 $325.00 $2,487.86
$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 $519.501 $443.361 $0.001 $100.001 $1,100.00 $0.00 $0.00 $0.00 $0.00 $325.00 $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 7/28/2009 Page 1
INDIANA RETAIL TAX EXEMPT PAGE
C ity Carmel CERTIFICATE NO.003120155 002 0 o 1i PURCHASE ORDER NUMBER
A -1 4 40 FEDERAL EXCISE TAX EXEMPT
0 1440 35- 60000972 „t
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
r SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR C7 L-�' SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
ff
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t
`3
Send Invoice To: t
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT Al _11g 7'
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
''-F'�- �'�"T'�''�' 1 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
fill VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID, THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. C
CLERK TREASURER
DOCUMENT CONTROL NO. C SIGN AND RETURN TO CLERK'S OF
VOUCHER NO.-- ..____.._-__.WARRANT NO..__..-.._...-.--_-
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
1 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
2040
ature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
PASSENGER R
Arrive Date Cabin Fare Code E- Ticket k: 012217170827h
Mpls /St. Paul, MN 223UL09 COACH V7R8N ISSUe Date: 230CT08
N Albuquerque, NM 223UL09 COACH V7R8N Name /Place of Issue: ,NWA.COM US E- TICKET TAR
Mpls /St. Paul, MN 26JUL09 COACH Q14R8N
I N Indianapolis, IN 26JUL09 COACH Q14R8N Endorsements /Restrictions:
NON- REFUNDABLE
i PENALTY FOR CHANGES
G L A 5 C Transportation subject to terms of carriage
e Thl S Ticket: USD 519 Tinted inside ticket 'acket.
445.58 Form of Payment:
14.00 E- Ticket 0122171703276 i I dr�LT}T
26. so Confirmation 00t7V.6
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11LIMijer 1 -SuO-468-3334
ROBERTS OIL #319
1517 GIBSON S.E.
ALBUO. HM 57107
ROBERTS OIL 39
1-17 GIBSOH
ALBUQUERQUE
P, V,
"OLR# 002'33155
DATE 37/2SI/09
ACCT#
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77S969P6HDiG
IHV# 111520 28/DD
LEE# 9 21 78 -033
AUTH #00 035822
PUMP# 9 SELF
UHL 13.305G
PRICElGAL $2. 499
FUEL TOTAL
THANK YOU PLEASE
COME AGAIN
THANK YOU
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Indianapolis International Airport
indianapolisairport.com
RECEIPT
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