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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 V pa0.T \Fq,i F C CITY OF CARMEL Expense Report (required for all travel expenses) k<AN t w• �!NDIPNP 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. i q 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