HomeMy WebLinkAbout168996 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 125575 Page 1 of 1
ONE CIVIC SQUARE MIKE HEINZMAN CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 C10 COMM CNTR
C/0 COMM CNTR CHECK NUMBER: 168996
CHECK DATE: 2117/2009
DEPARTMENT y ACCOUNT PO NUMBE IN VOIC E NUM BER AM OUNT DES CRIPTIO N
1115 4343002 125.00 EXTERNAL TRAINING TRA
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CITY OF CARMEL Expense Report (required for all travel expenses)
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Mike Heinzman 2/9/2009 TIME: AM PM
Carmel Clay Communications Center 2/11/2009 TIME: AM M
EMD -Q 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 $50.00 $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
WHO
Total $0.00 $0.00 $0.00 $0.001 i$0.001 $0.00 $0.00 $0.00 $0.001 $125.001 $0.00
DIRECTOR'S STATEMENT: I he i that all ex ses I onform 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 docume expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return.
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Employee Signatur Date: D
City of Carmel Form ER06 Revision Date 2/13/2009 Page 2
Priority Dispatch Register your course! rage t of
Choose by Discipline: t
international
Upcoming Courses EMD EFD II' 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: Ext. Home Phone:
Fax:
Agency Addr 1: Add 2:
City: County:
State /Province: Zip /Postal Code: F---
Country: F—�
Required to register for course.
Course Information
Course 15467
Type: EMD Quality Assurance F
Course Info Location: Lawrenceburg, IN
Start Date: 02/10/2009
End Date: 02/11/2009
•STOPI' if the above Is not the course you want to register for please, return to courses.
$550 USD ON -TIME REGISTRATION
Course Fee $5A5 WOO LATE REGISTRATION
Register today to avoid any additional fees for registrations within 10 days of the start date.
https: /www.xmission.com/ prioritydispatch/ courses courseregistration .php course_id =10314 1/7/2009
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 I I I $125.00
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.
Mike Heinzman ALLOWED 20
IN SUM OF
18934 Planer Drive
Noblesville, Indiana 46062
$125.00
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
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
Dire
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund