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Home My WebLink About172423 05/13/2009 a CITY OF CARMEL, INDIANA VENDOR: 357005 Page 1 of 1 ONE CIVIC SQUARE DAVID LITTLEJOHN CHECK AMOUNT: $1,127.09 CARMEL, INDIANA 46032 4840 N. GUILFORD AVENUE INDIANAPOLIS IN 46205 CHECK NUMBER: 172423 CHECK DATE: 5/1312009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION 1192 4343004 1,127.09 TRAVEL PER DIEMS CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: David Littlejohn DEPARTURE DATE: 4/25/2009 TIME: 11:55 AM DEPARTMENT: Community Services RETURN DATE: 4/29/2009 TIME: 7:10 PM REASON FOR TRAVEL: APA Conference DESTINATION CITY: Minneapolis MN EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM X Date Transportation Gas/Tolls/ Lodging Meals Misc. Total Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 7/25/09 $15.00 $183.71 $65.00 $263.71 7/26/09 $183.71 $65.00 $248.71 7/27/09 1 $183.71 1 $65.00 $248.71 7/28/09 $2.25 $183.71 $65.00 $250.96 7/29/09 $15.00 $35.00 $65.00 $115.00 $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 Total $0.00 $0.001 $32.251 $35.001 $734.841 $0.00 $0.00 $0.00 $0.00 $325.00 $0.00 DIRECTOR'S 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 5/1/2009 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. 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) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: City of Carmel Form ER06 Revision Date 5/1/2009 Page 2 I la dd David Littlejohn Room NO.' 0721 4840 Guilford Ave Arrival 04 -25 -09 Indianapolis IN 46206 Departure':" 04 =29 -09 US Page No.' o. 1 of 1 Folio No. 57339 INVOICE Conf. No. 436165 Membership No. Cashier No. 130 A/R Number Group Code TS014 Company Name Amer Planning Assn 04 -29 -09 Date Text Charges Credits 04 -25 -09 Room Charge 162.00 04 -25 -09 Tax 13.40 1/0 21.71 04 -26 -09 Room Charge 162.00 04 -26 -09 Tax 13.40% 21.71 04 -27 -09 Room Charge 162.00 04 -27 -09 Tax 13.40% 21.71 04 -28 -09 Room Charge 162.00 04 -28 -09 Tax 13.40% 21.71 04 -29 -09 1a 734.8/: Total 734.84 734.8 Balance 0.00 Join goldpoints plus today! Enroll in goldpoints plus at a participating hotel front desk or on line at goldpointsplus.com and start earning Gold Points ,today! Thank You For Staying With Us I agree that my liability for this bill is not waived and agree to be held personally responsible in the event that the indicated person, company or association fails to pay for any portion or the full amount of these charges. Guest Signature: Radisson Plaza Hotel Minneapolis 35 South Seventh Street Minneapolis, MN 55402 Telephone: 612 339 -4900 Fax: 612 337 -9766 Email: RHI_PLZ7 @r,adisson.com rtPp aaTU P aneq not, �Uegl :pied 18101 Lag, :uagwnN pjP; IIPM gy V p�PaUaIsPW 0 5 :993 IPlol 00 :aad xuT�JPd 00 @Ipb algPTAA MUM] Pajv POJy Aw00003 :101 Iol AM033 -J U m�Ln00 Z££Z£# Ia��T1 a 3 4 C\ b£# �asuadslp :pa�Tx3 TZ:ZZ 600Z /6Z /b0 K :paaalu3 �NO� b5 OT 600Z /5Z/b0 CD CD I6LVL :aagwnN not }oPSUPUI a, u as Ta :A TgSPO N� I£I# pI g S :,�agwnN .�alndwo0 aad o CL. 7 6£ `S1106PUPTpUI y NGC G :ti 4 *At ant ap TPT aowaW X000 atat� H Io0 008L liodi1v TPUOTIPuialul s1100PUPTpul x Z: E U c c c Z� y zHH as Cy ¢H n ma. J are Arrive Date Fare Code M E- Ticket Nbr: E0127532415627 rtiarapolis, IN Mpls /St. Paul, MN 25APRO9 Baggage Chg ISSL.,�d Date: 25APRO9 Name /Place c,f Issue: Indianapolis, IN Retai 'this receipt gal Pieces t USD15.00 EXB0122502526525 TfLEJOHN /DAVID Total Fare This i c.ket USD 15 0 0 �Firmation ibr: 2LYJDB E 15.00 Form of Payment: MASTERCARD Endorsements Restrictions Gard Nbr:. x•Xxxxx6902 Baggage iharge E- Ticket Nbr: EXBO122602526525 Transportation subject to terms of carriage 4L USD 15,.00 PASSENGER RECEIPT printed in< -ide ,ticket jacket Cnwa. J Depar Arrive Date Fare Code E- Ticket Nbr: E0127532415627 Mpls /St. Paul, MN Indianapolis, IN 29APRO9 Baggage chg Issued Date: 29APRO9 Name /Place of Issue: Mpls /St. Paul, MN Retain this receipt Total Pieces 1 USD15.00 EXBO122602678967 LITTLEJOHN /DAVID Total Fare This Ticket: USD 15.00 Confirmation Nbr: 2LYJDB FARE 15.00 Form of Payment: MASTERC -ARD Endorsements /Restrictions Card Nbr: X6902 Baggage Charge E- Ticket Nbr: 6127532415627 EXBO122602678967 Transportation subject to terms of carriage TOTAL USD 15.00 PASSENGER RECEIPT printed inside ticket jacket 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)) 04/29/09 David Per Diem Minneaplois $1,127.09 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 VOUCHER NO. WARRANT N ALLOWED 20 David Littlejohn IN SUM OF c/o One Civic Square Carmel, IN 46032 $1,127.09 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1192 43- 430.04 $1,127.09 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 Monday, May 11, 2009 irector, tocs Title Cost distribution ledger classification if claim paid motor vehicle highway fund