HomeMy WebLinkAbout169765 03/17/2009 CITY OF CARrAEI_., INDIANA VENDOR: 359065 Page 1 of 1
ONE CIVIC SQUARE BOB HIGGINS
CHECK AMOUNT: $2,383.72
CARMEL, INDIANA 46032 T e 16133HYMERAGREEN
WESTFIELD IN 46074 CHECK NUMBER: 169765
CHECK DATE: 3/1712009
DEPART ACCOUNT PO NUMBE INVOICE NUMBER A DESCRIPTION
1207 4343001 2,383.72 TPAVEL FEES EXPENSE
CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A►
EMPLOYEE NAME DEPARTURE DATE: �(1 T}�� TIME: AM M
DEPARTMENT: I i ��j`� RETURN DATE: Fe TIME: pp AM I
REASON FOR TRAVEL: r DESTINATION CITY: L
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT 2� TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. :Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
IV
.oU
Tonal
DIRECTOR 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 10117/2006 Page 1
Nursing v.
WorldPoints
Prepared for: RACHELLE A HIGGINS: January 2009 Statement �M�•
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f, {fi ma�a2 x FOrinforme6 Account Visit:
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w ww.bankofamerica.com
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Summa of Transactions Billi Cy and Payment Information Call toll -free 1 -800- 789 -6685
Previous Balance Days in Billing Cycle 32 TDD hearing- impaired 1 800 -346 -3178
Payments and Credits Closing Date 01/10/09 Mail Payments RI
Adjustments +s BANK OF AMERICA
Purchases and Ad
1 P.O. BOX 15019
Periodic Rate Finance Charges qpqW Payment Due Date 02/04/09 WILMINGTON, DE 19886 -5019
.....Current Payment Due $158:00.
Transaction Fee Finance Charges $0.00 Mail Billing lnquiries to:
Past Due Amount $0.00 BANK OF AMERICA
New Balance Total Total Minimum P.O. BOX 15026
Payment Due WILMINGTON, DE 19850 5026
P!' xdq y .m n x s�jG x3 f�.�`� 1 s �s/i �,y r6 '.s'ya,✓ r.?a�d� �y� yMi��
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Promotional Posting Transaction Reference Account
Pa and Credits Offer ID Date Date Number Number Amount
PMT FROM:BILL PAYER SERVICE 01/07, 200.00 CR
r u i-U
stMent
DELTA—OE7395809845
01/05. 01/02 .1756 3255. 358.40
HI GINS /ROBERTD,02 /03 IN MSY /I
E -3476 NV 01/05 01/03 6012 3255 32
EXPEDIA SERVICE FEES 800- 367-34._ 7.00 �n
01/05 01/05 21 39.00
01/08 01/07 4543 3255 161.81
WORLDPOINTS
MONTHLY EARNINGS
0 BONUS POINTS THIS MONTH
1 POINTS AVAILABLE
r 'rG a:.. "s r. s< —ya�v� s "f rrf x „u N x re �y. e j
n,'k s��'��_ zy�� �r' v.. p�. z_ ,u::, .a. �Z�Y,.,s'
IN ACCORDANCE WITH YOUR AGREEMENT, DEFAULT PRICING IS NOW IN EFFECT
ON YOUR ACCOUNT. YOUR APR WILL BE AUTOMATICALLY REDUCED FROM THE DEFAULT RATE
AFTER YOU MAKE THE MINIMUM PAYMENT DUE ON -TIME FOR SIX CONSECUTIVE
MONTHS WITHOUT GOING OVERLIMIT.
RESERVE YOUR 2008 YEAR -END SUMMARY TODAY. CALL 1- 866 491 -1141 BY 1 -30 -09 AND I
FOR ONLY $9.95, YOU WILL BE MAILED A DETAILED SPENDING SUMMARY BY 2- 13 -09.
ENJOY SPECIAL DISCOUNTS AT HERTZ.COM WHEN YOU USE CDP# 160018.
I
09 0048790600015800000200000005490355671403255
Check t II II III tI III I l lt t l l ll l ll II
Please provide ll ovdealllcorrection ontthe (s).
BANK OF AMERICA T x
P.O. BOX 15019 vfx r a��?, :.I
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WILMINGTON, DE 19886 -5019 ACCOUNTNUMBER:
NEW BALANCE TOTAL:
I�Illll�ll�tlltl��tt�Itl�llllllltl�lltll��ll�� "'III�I�I'I�Illttl PAYMENT DUE DATE: 02/04/09
SS 0113 N 216 694 27 12593 #001 AT 0.346
'if'�Y Enter Payment Amount Enclosed:
RACHELLE A HIGGINS
w
16133 HYMERA GRN
WESTFIELD IN 46074 8418 -332 Mail this payment coupon along with a ti
check or money order payable to: BANK OF AMERICA
I: S 2 40 2 2 2 S 0 1: LS88SG7b4032SSO
A XPOF TAN INFORMATION ABO THIS A CCO U NT U 211 Rev 04/08
CUSTOMER STATEMENT OF DISPUTED ITEM please call toll free 1.,966.266.0212 Monday Thursday Sam -9pnn (Eastern Time). Friday S am -7pni (Easteni
a
T i me) and Sati m
Sa-(apnr (Ea stern Time). For prompt service please have the inercbant reference nuubcr(s) available /or th charge(s) in question. J
PLEASE Do NOT ALTER WORDING ON'rH15 FORrNI AND DO NOT ,MAIL YOUR LE TI OR FOR+m WITH POUR PA)'\IENT. Choose only one dispute reason.
four Name: Account Nurnb r:
Transaction Date. posting Date: Reference Number
Anrounr S: Disputed Amount S: Merchant Name:
0 1. The amount of the Charlie was increased from S w s or m sales 0 S. I notified the men hint on (i \Ii�W AY)')') to Canard the pre authorized order
slip was added incorrectly. Enclosed is a cop" of ret� sales slip that shows the correct omounc (resen•ation). Please note cancellation and if a+ :nibble, enclose a copy of your contract and a
2.1 cenih' that the charge listed above was not made h m or a pe rson authonn m to use nc card, nor copy =of }xiueteky�me hill shoving date and rime rf cancel t, Cella on /cancpllation�k:
were. the 'WXKls or sci ices represented by the transaction received by m pt
e or a smonufh6riiel o nre.
3. I have not readied the merchandise that was to be shi a ed to ore on \I \UDD/ti')' 0 9. Ali] too ;h i did engage in the above transaction, I Bove contaael the merchant for credit. The sea ices to i e
I have asked the merchant to credit nn nccounI. provided on (i1It1A)D/Y)') owre• not revive{ or were unsntisfattom Attach a letter
4.1 \vas issued a ttctlit slip that was not sh n m stater
net oil stateent. r\ copy of me credit slip is eulusal• descrIhing the senwices expe"tcd, your attempts to iisolve with the merchant and a copy of your contract.
llie it has up to •10 clays to credit your account. 10.1 certify that I do not rcecaguize the transaction. Merchants often provide telephone nundaers next to their
5..Merchandise that was shil�ppCc It tae has orrice lama •Cd aneUnr dehetive. I rcnumc it on narne on your billing statement. please attempt to contact the merchant for information.
(NISi/DD/Y)') and asked the meri cant to credit my account. Attach a letter describing I I" If your dispute is for a dif*cgt rc�s }w, please contact its at the above telephone number.
haw the naert handise was damaged and/or defetiyc and a copy of the pnl, of remm. roa.x,
0 6. Although I did enpige in the above transaction, l have cons ;aaed the merchant, renimed the merchandise Signature (required): a Date:
on (i\L \I/DD/Y and requested a cralit. I either did not nYeive this credit or it was Rest contact telephone cw �i°"'u'N 1-lonre
unsrtistaaom Attach a letter explaining a\ -h% y ou are disputing, this charge with a copy of the proof of
Ivturn.If you are unable• to return the ntc•rehandix•, pl m,cxplain. Billing ri lv_; nre only preserved bgwritreu inquiry. lie presence your billing rights, please return a
7. I certify that the charge in question was a single tranvu but was posted twice to my statement. copy of r its forni and any' su porting informauori regarding the merdmnt charge in question to:
1 did not authorize the' second transaction. Sale #I S Reference Ain: Billing Inquiries, 10. Box 1i026, Wilmington, DI: 19550 -5026, USA.
Sale #2 Reference P I_FASFKIT1'TiIFORIGNIAC'1r01t'1 i iRFCORDSANDSF•N1DA(:OPYOFI I1SSTATPS4ENi'.
GRACE PERIOD lb calculate the daily balance for each clay in this statement's billin� cycle, we take the.
"Grace Period" means the period of time during a billing cycle when you will not accrue beginning balance, add an amount equal to the applicable Daily Pc6oclic Rate multiplied by the
Periodic Rate Finance Charges on certain transactions or balances. There is no Grace Period for previous days daily balance, add new Purclases, new Account Fees, and new'I "ransution Fees,
11alance Gansfers and Cash Advances. If you pay in full this statement's New Balance "final by and subtract applicable payments and credits. If any daily balance is less than zerh we treat it as
its payment Due Date and if you paid in fill this statement's previous Balance in this statement's zero. if the Previous Balance shown on this statement was paid in full in this statement's hitting
hitting cycle, then coil will have a Grace period during the billing cycle that begin the ciao. after cycle, then on the clay after that payment in full date, we exclude from the beginning balance
this statements Closing Date on the Purchase lx)rtions of this sttarenaents Ncw Balancc Natal. new Purchases, new Account Fee` and new Trantiiction Fors which posted on or before that
i)uring a 0'Y„ 1'ronxxional Rare Offcr: 1) nu Pericxlic Ratc Finance Charges accrue on payment in FullAue, and we dry not add new purchases, new Account Fees, or new Transaction
balances with the 0% I'ronotional Rate, and 2) y ou must pay the "Natal Nlininunn I'ayment Fees, which post after that paynent in full date.
Due by its Paanncnt Due Date (and avoid any other "promotion turn-off event" as defined in We include the costs for the credit card debt cancellation plan or creclit insurance purchased
vour Credit Gard t \grecment) to maintain the W4, prom irtionat Rate. through u- in calculating the beginning balance for the first day of the hitting cycle after the
If a correspcmding Annual I'ercenta ge Rate in the Finance Charge Schedule on the front billing cycle in which such costs are billed.
Of this statement contains a stint x)], then with ru;p ct to those balances: d) the W/ TOTAL PERIODIC RATE FINANCE CHARGE COMPUTATION
1'romotional Rate: will expire at the end of the next billing cycle, and 2) you must pay this periodic Rate Finance. Charges accrue and are currpoiriiilttd'd)n a dailvalxaSrs Tci'e'Ii+f r 7 s"
sratenaents N, "lbtal by its I'a}kDue Date ti ;algid 1 u nexhc f<t,}Einancc Char?tlje Perialic Rate Finance Charges, we mulnplj Cara Balance SithlecFrq FiiirtficevC h t :r
after the end o the U'% I ronaotional Rate Offer on those balances existing as nF the Closing applicable Daily Periodic Rate and that re It by tli� number cif'd aysam ;tlic hdlittg'•�i%c :+<t.
Date of this statement• determine the total pericxlic Rate Finance Charge fin' the billing cycle, We add the 1'ericxl ztti
CALCULATION OF BALANCES SUBJECT TO FINANCE CHARGE Finance Charges together" Each Dail)' 6y:dividjng ii yrv,fx�ndt2ag•,
Average Balance N /ethod (including new Balance lransfers and new Crash Advances): Annual percentage Rate by 365.
\i ealcrdatc separate Balances Still to Finance Charge for Ralancc l ransfers, Cash Advances, HOW WE ALLOCATE YOUR PAYMENTS
and for •at )motional Offer ba cc consisting of Balance Transfers ransfers or Cash Advances. ces. \lye We Will allocate your payments in the nianner we determine. In most instances, we will
do this n alcu a Mail}' h, acc for each day in this statenunt's billing cycle; allocate yo •a y incnts to balances (including transitions made after this statement yvith lower
calculann 'a d'aly 'r each cJ[,i )riot to this statements billin cycle that had a "I'rr r
g I R ApRs {afore balances with higher Ai Rs. this will'result in balances with lower AI Rs (such as
Cvde balance" a cle balance is a lialance "transfer or Cash Advance with a transaction new halage2k ��itlu� romorional r1PR offers) heingpaid before any other existing balances.
dare prior to this statement's billing cycle but with a p)sting date within this sratcnacnt's billing Payment Due Dates and Keeping Your Account in Good Standing
cycle; (3) adding all the daily balances together; and (4) dividing the sum of the daily balances by )'our payment Due Date Will not fall on the da each month. in order to help maintain
the nwnLKr of days in this state ment's billing cycle. any promotional rat(s, to avoid the imposition of C)efault Rates (if applicable), to avoid late fees,
To calculate the daily balance for each clay in this statement's billing gcle, we take the
beginning inning balance, add an amount equal to the applicable Daily pericxlic Rate nridtiplied by the Pay av e each hitting r arlc ad r ec ei v e cau rnnimuain your aca> balance n r Dit khwt
previous day's daily balance, add new Balance "1'mnsfers, new Cash Advances and and Payment Due Date
g t be our
Transaction Fees, and subtract applicable payments and credits. If any dail balance is less than Credit Limit each days
zero \vc treat it as zero. Important Information about Payments by Phone
To calculate a daily balance for each cloy prior to this statement's billing Cycle that had a pre- \\Then using the optional Pay- hy-1'hone servia you authorize its to initiate nn electronic
Cycle balance, we take the beginning balance attributable solely to pre -Cycle balances (Which payment from account at the financial institution you desitgtlate. )iii must authorize the
will be zero on the transaction date of the first pre -Cycle balance), add all amount ec cal to the amount and timing of each payment. For your }}lto tection, we Will ask for secu m
rity inforation.
applicable Daily ieriodic Rare multiplied by the previous days daily halancc, and au�d onto the A for may apply. to cancel, call its before the scleduted payment date. Same -clay payments
applicable PreZycle balances, and their Id tcd iransnction Furs. \he exclude fl this cannot lx edited or canceled.
calculation all transactions bolted in previous billing cycles. MISCELLANEOUS
Average Daily Batancc (including new Iurchases): We calculate separate Balances For the complete terms and conditions of vour account, consult your Credit Card
Subject to Finance Charge. for i' irchascs and for each 1'ninotionab Offer balance consisri!hg of grcrnient. FIA Card Services is a tradc is of Flt\ Card Services, N.A. This account is issued
purchases. We do this hc: (1) calculating a daily balance for each day in doe billing c (2) gr administered by FIA Gard Set•ic(-, N.A.
adding all the daily' balances together, and (3) dividing the still) of the daily halancc, by the
number of days in the hifling cycle.
PAYMENTS
We credit payments as of the date received, if the payment is 1) received by 5 p.na. If vour billing address or contact information has changed, or if your
(Eastern lime), 2) received at the address shown in the bottom left -hand corner of the front address is incorrect as it appears on this bill, please provide all
Wrhis statement, 3) paid With a check drawn in U.S. dollars on a U.S. financial institution or corrections here.
a U.S. dollar money order, and 4) sent in the enclosed return envelope with only the bottom
portion of this statement accompanying it. I'aynaents received after 5 p.m. on any clay Address I
including the payment Due Date, but that otherwise meet the above requirements, will he
credited as of the next (lay. We will reject payments that are not drawn in U.S. dollars and m
those drawn on a financi i unniti a located outside of the United States. Credit for any Address 2 W
Other payn)cni may be c i1 *fide fia`t's!`- payment shall operate as an accord and N
satisfaction without the prior written agg �g� }I of one of our Senior Officers. Cit o
We process most payment checks`lwsY'cin`IC;aldy by using the information found on your o
check. Each check authori its to create a one -time electronic funds transfer (or process it
as a check or paper draft). Funds 1113V b withdrawn from our account as soon as the Snare Zip
same day we receive your payment. Checks are nor returned to you. For more information
or to stop the electronic funds transfers, call its at the number listed on the front. Area Code 8
If you have authorized its to pay your credit card bill automatically from }'our savings or i Gone Phone
checking account with us, you can stop the payment on any amount you think is wrong. To Area Code cC
stop the payment your letter must reach its at least three business days before the automatic Work Phone
payment is scheduled to occur.
C t/l -Gt
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assistance e-mail form. itinerary #125998307124). Yew our interactiv demo.
Q Viewyour complete top details Egfl /FAX'
Vacation Package: Indianapolis to New Orleans Package booking $1,465.48
cost
Flight: indianapolls to New Orleans
Taxes 8 service fees: $221.04
Traveler name: Robert Higgins
Package total: $1,686.52
Indianapolis (IND) to SL 02/03109 5:55 pm 6:00 American Airlines
Louis(STL) pm 5300 operated
By: /AMERICAN
CONN ECTION /C HAUTAUOUA
St. Louis (STL) to New 02!03109 7:20 pm 9:10 American Airlines
Orleans (MSY) pm 5348 Operated
By /AMERICAN
CO N N ECT I O N ICHA UTA UO UA
New Orleans (MSY) to 02/08/09 4:00 pm 7:13 Delta 6158 Operated
Cincinnati (CVG) pm By: Chautauqua
Airlines
Cincinnati (CVG) to 02108109 8:05 pm 9:00 Doha 6158 Operated
Indianapolis (IND) pm 8y: Chautauqua
Hotel: Embassy Suites Hotel Now Orleans Airlines
Room reservation: Robert Higgins 1 adult
Embassy Suites Hotel New Orleans
��ree�� uutt �SSuu ??!/8 r�
'a8Pd&TdPt�t'2'�Tcar, New Vr1 89 l.5k7# r1 9 Nights:5
Driver. Robert Higgins
Compact Car O
PIck'up: Tue Fetr3= 2009'9:00'pm Drop'oR'Sun FebA= 2009 4:00'pm 1�
OQ View_ygur_com tri details V
1 Total": $1,686. 2
This total includes selected items, taxes, and service fees. Unless sperifred otherwise, rates are quoted in USD. Car
taxes and fees not induced,
Traveler requests
We will forward your requests to the travel vendor, but as these are subject to availability we can not guarantee that they
will be honored. Some special requests (e.g., ski racks, rollaway bads) may incur additional charges from the vendor.
Free and special meals are not available on many flights.
Hotel: Embassy Suites Hotel New Orleans
Room: Two Queens Suite Non Refundable
Nonsmoking/Smoking: Non Smoking
Room type2 QUEEN BEDS
Vi e".our itinerar for complete and up-to -date trip details, or to make changes online.
Customer Support
Itinerary number. 125998307124
If you have questions about your reservation, fill out our itinerar assistanc form We'll respond within
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http://www.expedia.com/pub/agent.dll?qscr- A305JGDC$21$8E$D5... 1/2/2009
Dear Expedia Customer,
Thank you for contacting us about your vacation package.
We apologize for this inconvenience. Unfortunately, for packages, we will not be able to
provide you with a breakdown of the rates. Since you have booked a package deal, the
rates given would be for the whole package. We are not privy to the breakdown of the
package rate since these are contracted rates with our vendors.
However, when you purchase a vacation package online, there would be instances when
the charges would be posted separately in the credit card. This would be when you
purchase a package with nonrefundable tickets. These tickets are called published fare
tickets. In cases like these, Expedia will be the one to charge for the hotel portion of the
package and the airlines will be the one to charge for the airfare tickets. If you've checked
on the credit card charges online, most likely you will see the charges for the hotel
portion posted first and eventually, the charges for the tickets will also be posted.
If this does not answer your question or solve your problem, feel tree to reply to this
messaue or call us at 1- 800- EXPEDIA (1- 800 397- 3342) and reference case !D
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315 Julia Street New Orleans, LA 70130
Phone (504) 525 -1993 Fax: (504) 525 -3437
V. M 6 ASS V Sur •r r S For reservations across the nation
Name Address F1 O T E L S• www.embassysuites.com or I -800- EMBASSY
HIGGINS, ROBERT Suite 548/TDBN
Arrival Date 2/3/2009 11:01:00PM
Departure Date 2/8/2009 9:10:OOAM I
Adult/Child 1/0
Suite Rate
RATE PLAN S -AH1
HH# G ic
AL:
CAR:
CONFIRMATION NUMBER: 80846499
t
2/8/2009 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT TheHiltonFamily
2/3/2009 3579055 PARKING: GUEST $28.00
2/3/2009 3579055 TAXES $3.36
2/4/2009 3580328 PARKING: GUEST $28.0 Hilton
2/4/2009 3580328 TAXES $3.361
2/5/2009 3580614 ROOMSERVICE $18.57
2/5/2009 3580615 ROOMSERVICE ($18.57
2/5/2009 3580616 ROOMSERVICE CON Ell
2/5/2009 3581232 PARKING: GUEST 0
2/5/2009 3581232 TAXES $3.36)
2/6/2009 3582221 PARKING: GUEST $28.0
2/6/2009 3582221 TAXES $3.36' n
2/7/2009 3582994 PARKING: GUEST $28.0 Do BLET RE E'
2/7/2009 3582994 TAXES $3.3�
2/8/2009 3583200 ($179.37)
BALANCE $0.00
Garden Inn•
ACCOUNT NO. DATE OF CHARGE FOLIO NO. /CHECK NO. iRo
Hilton
Grand Vacations Club•
02/06/09 04:55:00 471668 A
CARD MEMBER NAME AUTHORIZATION INITIAL
HOMEILOOD
SUrm
ESTABLISHMENT NO. LOCATION 1- Mf1T1SnMFxr A(;Rirs M Iw NSnur MCA�11013) MRPArmirr PURCHASES SERVICES MI
TAXES
TIPS MISC. u SS
CARD MEMBER'S SIGNATURE
X TOTAL AMOUNT 179
Official Sponsor
I
315 Julia Street New Orleans, LA 70130
Phone (504) 525 -1993 Fax: (504) 525 -3437
E M B ASS Y S U T 7' E S For reservations across the nation
Name Address HOTELS www.embassysuites.com or 1 -800- EMBASSY
HIGGINS, ROBERT Suite 548/TDBN
Arrival Date 2/3/2009 11:01:OOPM
Departure Date 2/8/2009
Adult/Child 1/0
Suite Rate
RATE PLAN S -AH1
HH#
AL
BONUS AL CAR
Confirmation: 80846499
2/8/2009 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT
2/3/2009 3579055 PARKING: GUEST $28.00
2/3/2009 3579055 TAXES $3.36
2/4/2009 3580328 PARKING: GUEST $28.00
2/4/2009 3580328 TAXES $3.36
2/5/2009 3580614 ROOMSERVICE $18.57
2/5/2009 3580615 ROOMSERVICE ($18.57)
2/5/2009 3580616 ROOMSERVICE $22.57
2/5/2009 3581232 PARKING: GUEST $28.00
21512009 3581232 TAXES $3.36
I 2/6/2009 3582221 PARKING: GUEST $28.00
2/6!2009 35822.21 TAXES $3.36 Y
2/7/2009 3582994 PARKING: GUEST $28.00
2/7/2009 3582994 TAXES $3.36
WILL BE SETTLED TO $179.37
EFFECTIVE BALANCE OF $0.00
ESTIMATED CURRENCY TOTAL
EXPRESS CHECK -OUT DATE OF CHARGE FOLIO N0.lCHECK N0. Al 7 Good Morning We hope you enjoyed your stay. With Txpress Check -Out AUTHORIZATION ITIAL
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
evening. PURCHASES SERVICES
For any charges after your account was prepared, you may:
pay at the time of purchase. TAXES
charge purchases to your account, then stop by the Front Desk for an
updated statement.
or request an updated statement be mailed to you within two business days. TIPS ItISC.
Simply call the Front Desk from your suite and tell us when you are ready to
depart. Your account will be automatically checked out and you may use this
TOTAL A \10UN'1'
statement as your receipt. Feel free to leave your key(s) in the suite. 0.00
Please call the Front Desk if you wish to extend your stay or if you have any
questions about your account.
Rental Location Vehicle Information Rental Ex fires On -Rental Agreemenl Number
U UPI: 1 4 i n 1 t IJ;_�[ 44 i Jess" 074428 -6
rt�rrnrGar, To e f Llturned To Ab ve Unfess Stated Below I E be AEF442' STaiL l�? l 21 i 16N IN01SS?G
i NE NER "LA W0 @8 MRYSLEF SE N BRU I)
tCSE? 3'a -Ec 6 Rate: PYTAN [15: STAR 5169 TIME OUT TIE IN
t=LEL LEVEL GUT. FULL. 1e /a3lc"W 21:1
MILEAGE OUT: 35649 g0ENTAL RATES** CST OiB
lours 3.n @Is
Customer Information CUSTI;NICR DECL INES LDW AND IS RISPeN- )a5-s ?9 =+131 MI:
BIBLE FOR LOSS OF( IMAGE TER T[R.k§ 4eehs 'W'. of. NIS
OF THE RENTAL A G R E u z In l i g A d I> I S
UWfp DECLINED uel 5.331031
.0 DECLINED 3TATE T4 6.750% 18. I;7
pPP MCLINaT:G TNdTAL TAR 3'. 11Z wr
IPC 124RECFEi 11.1 I V
MIGGIN'S ROBERT BY YOU IddITT 3'Y rl t., DGE YOU 1USTtr1R FAC 5.501111ay 1a1�� 1kYiRA iiP� HAVE TtCCLP OR W;ERt�; THE E =NdEGY F,CW]U 4ti'D3v :A� WTESTFIELD IN 4W74 OPTION. Tf��lSF K I ESTIrATEIi Clit?Ws"E
74715 IN 07/810@9 317- 83£,- 1IRf@5 INCLUDES 5 tfff 0.I1CHER
ADDIL DRIVER: Nrne f0UR CREDIT CARD WILL BE CNARGEII FOR ILL CITATION PENALTIES AND TOLL P.DAD
)IOLATIONS (IN VIOLATI
PTU4I0 BY CAli-E P' M
IMIN FEE PER I) "QW 3`ItllNFr it
DRIVING RESTRICTED "Y ORIGINAL DATE K o�I.W
TO Cain l*NlTAL US :STINATED1 iURW CW itGC�' Ia(2`�'
CREDIT CARD AtnORIZRTIGr, uITs
LOUISIANA OPTIONAL LOSS DAMAGE WAIVER ("Lbw)
l:Iil l sIAJ
NOTICE: IF YOU HAVE COLLISION COVERAGE UNDER YOUR OWN AUTOMOBILE INSURANCE POLICY WRITTEN IN LOUISIANA,
YOUR COLLISION COVERAGE AUTOMATICALLY EXTENDS TO RENTAL VEHICLES PURSUANT TO R.S. 22.1406 (F).
EVEN IF YOU ARE NOT A LOUISIANA INSURED, THE PURCHASE OF LDW IS NOT MANDATORY AND MAY BE WAIVED. THE
CONTRACT OFFERS, FOR AN ADDITIONAL CHARGE, A LDW TO COVER YOUR RESPONSIBILITY FOR DAMAGE TO YOUR VEHI-
CLE. BEFORE DECIDING WHETHER TO PURCHASE LDW, YOU MAY WISH TO DETERMINE WHETHER YOUR OWN AUTO
MOBILE INSURANCE AFFORDS COVERAGE TO YOU FOR DAMAGE TO THE RENTAL VEHICLE AND T HE AMOUNT OF THE
DEDUCTIBLE UNDER SUCH COVERAGE.
These terms supersede any conflicting terms stated elsewhere.
The Rental Agreement is between the undersigned and the company identified above (the "Company"). By signature below, the undersigned acknowledges and represents that they are legally authorized to operate the rental vehicle
by valid driver's license, and that they have read and agree to the terms, conditions and notices, both printed and written, including the Loss Damage Waiver information, that appear on this Rental Statement and on the separate
rental jacket (the "Agreement which is incorporated herein. THE UNDERSIGNED AUTHORIZE THE COMPANY TO PROCESS A CHARGE TO THEIR CREDIT, DEBIT OR CHARGE CARD IN THE AMOUNT SPECIFIED ABOVE
FOR THIS RENTAL UPON SIGNATURE BE'OW AND FOR ALL ADDITIONAL CHARGES DUE UPON RETURN OF THE VEHICLE, ALL CHARGES SUBJECT TO AUDIT. No additlonal drivers are permitted without the
Company's approva
X t I RENTER X ADDITIONAL DRIVER
Edit Centralized Order Entry Page 1 of 1
L C i"
golf Industryshow
Shopping Cart I Receipt
Thank you for your order. j
Your Invoice Number is 122834 You may Print this page for your records. f
item price
Member Full Conference Package 1$275.00
Comprehensive Golf Couse Environmental Management Planning $75.00
Guest
Billing Shipping Information
Customer name: Higgins Robert D Billing name: Higgins Robert D
Email: rdhiggins7 @msn.com Contact: Higgins Robert D
Phone: (317)846.7431 I I
Shipping label: Mr. Robert D Higgins Billing label: Mr. Robert D Higgins
16133 Hymera Grn 16133 Hymera Grn`a
Westfield, IN 46074 -8418 Westfield, IN 46074 -8418
UNITED STATES UNITED STATES
I
I
Payment Information
Payment amount: $350.00 Net total: $350.00
Payment method: Credit Card Net- applied: $350 -00
Cardholder's name: ro ert d higgins Net balance: $0.00
Credit card number:
Expiration date: 2011/09
Authorization code: 045938
Reference number: 122834 I
f i
i
Finish
If you need assistance with this registration process, please call GCSAA customer solutions
at 800 -472 -7878 or 785- 841 -2240 between the hours of 7:30 am and 5:00 pm CST
https: /netforum. gesaa.org /e Web/DynamiePage.aspx ?W izardKey =63 786742- 17ce- 4e51 -8c... 12/4/2008
r
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
o n's .14 r CC i') C Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0
0!2
v 09 /v D9 J cz Fe- U(p Utz
&)9 116 9 /32,. /-2
11101 a r 4t-�- 7 3 VO
Total q
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. "W
ALLOWED 20
r G dg I�r �S IN SUM OF
ZI
WACC &LINT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
oZo�
A) 9 �7 0( bill(s) is (are) true and correct and that the
/2- -Q 30 7W materials or services itemized thereon for
/o-d 30.103 which charge is made were ordered and
/moo "-/0 Z1 36 -6 received except
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20
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund