HomeMy WebLinkAbout176300 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 of 1
ONE CIVIC SQUARE JOHN JOKANTAS CHECK AMOUNT: $407.06
?o CARMEL, INDIANA 46032 C/O COMM CENTER
CIO COMM CENTER CHECK NUMBER: 176300
CHECK DATE: 8/1912009
D EPARTMENT ACCOUNT P O NUMBER INVOIC NUMBER AMOU D ESCRIPTION
1115 4343004 407.06 TRAVEL PER DIEMS
CITY OF CARAMEL Expense Report (required for all travel expenses)
�'�h!OIAN,b
EMPLOYEE NAME: _John M Jokantas DEPARTURE DATE: 7/28/2009 TIME: 5:30 AM A M PM
DEPARTMENT: Communications RETURN DATE: 7/31/2009 TIME: 8:OOPM AM PM
REASON FOR TRAVEL: CALEA Conference DESTINATION CITY: Hampton Virgina
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 9 Breakfast Lunch Dinner Snacks Per Diem
7/28/09 $65.00 $65.00
7129/09 $65.00 $65.00
7/30109 $65.00 $65.00
7/31/09 $65.00 $65.00
$0.00
7/28/09 $25.35 $25.35
7/28/09 $34,61 $34.61
7/29109 $20.71 $20.71
7/31/09 $35.96 $35.96
7/31109 $10.15 $10.15
7/31109 $20.28 $20.28
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
Total $0.00 $0.001 $0.00 $147.06 $0.00 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00. e
DiRECTOR'S STATEMENT: I h that all exp ses li d 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 8/14/2009 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 ei deduced ro e first paycheck issued more than 30 days after the date of my return.
Employee Signature: Date: E v
City of Carmel Form ER06 Revision Date 8/14/2009 Page 2
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-Fra:
REGISTRATION FORM
Hampton, Virginia July 29- August 1, 2009
or register online at www.calea.org
Agency Name
Address
City /State /Zip
Contact Person
3 1 7 S a Po9-rmd
Telephone Email V
&l C.Q. rna n o r-
Individual Name Title PrefeiYed F rst Name
k h
Individual Name Title Preferred Virst Name
Individual Name Title Preferred First Name
Before 7/15/09 After 7/15/09
K rk on ce x $465 _x $480
s Onl a---x$435 0.a $450
o Agency —x $115 —x $115
Banquet Only _._,x 65 65
*Attending Saturday Activities Only
Any Agency registering 4 or more persons for the FULL conference will receive a $10
per person discount.
Payment Information:
Purchase Order Number: a
Credit Card: Visa MasterCard Q
Account Number Expiration Date
Mail, Fax, or Email form to:
CALEA Phone: 703- 352 -4225 or 800 368 -3757
10302 Eaton Place Fax: 703 -591 -2206
Suite 100 Email: wjones @calea.org
Fairfax, VA 22030
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))
08/14/09 I I I $407.06
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 N W NO.
ALLOWED 20
John Jokantas
IN SUM OF
634 W. 136th Street
Carmel, Indiana 46032
$407.06
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1115 43- 430.04 $407.06 I 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, August 14, 2009
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund