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Home My WebLink About174598 07/15/2009 CITY OF CARMEL INDIANA VENDOR: 360934 Page 1 of 1 1 E ONE CIVIC SQUARE CAMERON MASON CARMEL, INDIANA 46032 3943 S 400 E CHECK AMOUNT: $102.30 TIPTON IN 46072 CHECK NUMBER: 174598 CHECK DATE: 7/1512009 EPARTMENT ACCOUNT PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION 2201 4343002 102.30 MILEAGE i www.CarteGraph.com 4 i r City of Bloomington, IN \V %ATERvieu 317 -660 -6611 Lou Stonecipher PAVEivtEN'Fvieiv jell @ctwd.org Systems Analyst PA A R I NGviery 812- 349 -3466 Colleen Byrnes stonecil @bloomington.in.gov City of Elkhart, IN 317- 873 -0564 Brent Graybill Andrea Roberts Traffic Operations Supervisor Software o� �ea r� Ct- y t�stail>' Deputy Director of Public Works WORKdirecfor p Y 574 522 -2884 812 349 -3411 brent.graybill@coei.org CA.LI..(firector robertsa@bloomington.in.gov SEWERview Nl A Pdirectoi- Soft�vare owned by h['•ahr�rt: Joe VanDeventer SIGNview Assistant Superintendent WORKdirector Johnson County, IN 812 349 -3448 NI APdirector Lucas Mastin vandevej @bloomington.in.gov Project Designer 317 346 -4641 Lisa Bowlen a City of Carmel, IN imastin @co.johnson.in.us Secretary 812 349 -3448 Terry Krueskamp bowlenl @bloomington.in.gov GIS Coordinator Valparaiso Utilities 317- 571 -2565 Vera Trikilis Laura Haley terry.l<rueskamp t)carmel.in.gov Work Management Assistant Champion GIS Manager 219- 464 -4973 812- 349 -3599 Amy Lunn vtrikilis`wvalpo.us haleyl @bloomington.in.gov Office Assistant 317-733-2001 Dick Condon Kasie May alu Crew Leader Communications Operator Public Wor 812 349 -3400 Cameron Mason Software ovrne.d by VaLparaiSo: mayk @bloornington.in.gov G.IS Tech WORKdirector 317- 133 -2991 CAU..director Eli Eccles cmasonpC?carmel.in.gov SEII'ERview Engineering Technician WATERview 812- 349 -3598 ,t, are o��net1 u:rrnet: ecciese @bloomington.in.gov WORKdirector CarteGraph Systems Deb Vollmer City of Franklin IN Greg Maim Account Clerk Rick Littleton Territory Manager 812 349 -3452 800 688 -2656 ext. 6174 Public Works Superintendent vollmerd @bloomington.in.gov 888- 736 -3640 gregmalm @cartegraph.com riittleton@franklin- in.gov Christina Fulton Emily Steffen Project Manager Softy, ate owned by Franklin: Account Manager 812- 349 -3589 \X'ORKdirectnr 800 -688 -2656 ext. 6250 fultonc @bloomington.in.gov C.ALLdirector emilysteffen @cartegraph.com r SEIt'ERview Software owned by nloon,in `.on: Dave Samson WORKdirector Clay Tom. shi I Regional Manager SIG\ view Jeff 800- 688 -2656 ext. 6118 SIGNALvie'v G ch davesamson @cartegraph.com in d a d r 't 0 0• d D Prescribed by State Board of Accounts General Form No. 101 (1955) nR, IVIILEACE CLAIM A auk TO DR. (Governmental Unit) _&Ct-, On Account of Appropriation No. 460. Q, for (Office, Board, Department or Institution) DATE FROM TO ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE a 5 5 20 OC Point Point Start Finish TRAVELED PER MILE 0A YY\ 7 r5 Loo w 6 1 I bo 10 fo Auto License No. TOTALS 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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been paid. Date 0 Claim No. Warrant No. I have examined the within claim and s hereby certify as follows: IN FAVOR OF 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 On Account of Appropriation No. for Disbursing Officer N Allowed 20 (D 0 O ��5 in the sum of Q-4- n (D CQ 5 (D G (D o (D (Board or Commission) C ?e 90 1 (D n FILED o s2 m 9 L m (official Title) En O 6 e (D a �pP Rf� CITY OF CARMEL Expense Report (required for all travel expenses) N01 AN P EMPLOYEE NAME: O n MASbq DEPARTURE DATE: (0/j6/ C TIME: C 7 60 M )PM DEPARTMENT: RETURN DATE: W,�3 1 0 5 J TIME: 4 ,i ,'dO AM PM REASON FOR TRAVEL: Cann DESTINATION CITY: 'v O nrn 1, n O' kti EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT V TRAVEL PER DIEM 160 m�. X 66' Pa mi IL Transportation Gas /Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem 6/23/09 $102.30 $102.30 $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 1 r $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 Total $0.00 ;$0.00 $0.00 $102.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 e o DIRECTOR'S STATE MEhl I that all ens I' t co for to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: Street Commissioner City 6f Carmel Form ER06 Revision Date 6/26/2009 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 10 Z. 60 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 is 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) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: i Date: City bf Carmel Form ERO6 Revision Date 6/26/2009 Page 2 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)) 06/26/09 $102.30 I 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 VOUC NO. WARRANT NO. ALLOWED 20 Cameron Mason IN SUM OF c/o Street Department $102.30 'ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 43- 430.02 $102.30 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 d dne�jjy, July 01, 2009 Street ComTis' loner Title Cost distribution ledger classification if claim paid motor vehicle highway fund