HomeMy WebLinkAbout172916 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 356917 Page 1 of 1
ONE CIVIC SQUARE MELANIE LENTZ
s CARMEL, INDIANA 46032 8440 E 131 ST STREET CHECK AMOUNT: $728.48
FISHERS IN 46038 CHECK NUMBER: 172916
CHECK DATE: 5/27/2009
DEPARTMENT ACCO UNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343002 508.62 EXTERNAL TRAINING TRA
1160 4343004 219.86 TRAVEL PER DIEMS
�aM ERsi
CITY OF CARMEL Expense Report (required for all travel expenses)
NO,pyP. EXHIBIT A
EMPLOYEE NAMEE:���� an l e L e fiz DEPARTURE DATE: l�- d TIME: 2 AM PM
DEPARTMENT: V e T eM ons RETURN DATE: 9' 1 9 09 TIME: AM M
REASON FOR TRAVEL: I V 71T O ��D1n�C.� 2.�CJZ. DESTINATION CITY: S r
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Taxi Tips Luggage Parking Breakfast Lunch Dinner Snacks Per Diem
I o
_A
i v CQS
Total
DIRECTOR'S STATEMENT: I here y affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: 1/� Date:
City of Carmel Form ER06 Revision Date 9/25/2008 Pagel
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 $65 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 $65 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) 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 9/25/2008 Page 2
Northwest Airlines Trip Summary and Receipt 17MAY #OE3ZVQ Pagel of 3
From: Northwest Airlines <webuser @lists.nwa.com>
To: NHECKLAW @AOL.COM
Subject: Northwest Airlines Trip Summary and Receipt 17MAY #OE3ZVQ
Date: Mon, 27 Apr 2009 3:09 pm
W--
ter.:.,, f
v nwa. mm
nwa .com.
Trip Summary and Receipt check -in
*OE3ZVQ* within 24 hours of your flight.
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NWA Confirmation Number: OE3ZVQ
Passenger Name E- Ticket Number Frequent Flyer Number
HECK/NANCY.S 0122179131145 NW100508201360
LENTZ/MELANIE.J 0122179131146 none
The following fligh ar e confirmed:
Date: Sunday, May 17 Flight: NW 2194
Departs: Indianapolis -Intl, IN (IND) at 10:35AM •I
Arrives: Washington- Reagan National, DC (DCA) at 12:10PM
Class of Service: Economy Class (K) Seat: 07 -A Window, 07 -B Aisle
Flight Duration: 1 hour 35 minutes Approximate Miles: 487
Meal Service: None Aircraft: Canadair Regional Jet CPJ
Note: Operated by PINNACLE AIRLINES /NWA AIRLINK
Note: Check in with Northwest Airlines
Weather forecast for Washington- Reagan National, Plan your trip to Washington Reagan National, DC
DC (DCA) (DCA)
Content is provided solely by Frommers. com and the opinions
Make a reservation in Washington Reagan National expressed do not necessarily reflect the opinions of Northwest
D C D C A) Airlines.
Date: Tuesday, May 19 Flight: NW 2193
Departs: Washington- Reagan National, DC (DCA) at 5:15PM
Arrives: Indianapolis- Int'I, IN (IND) at 7:07PM
Class of Service: Economy Class (K) Seat: 09 -A Window, 09 -B Aisle
Flight Duration: 1 hour 52 minutes Approximate Miles: 487
Meal Service: None Aircraft: Canadair Regional Jet CPJ
Note: Operated by PINNACLE AIRLINES /NWA AIRLINK
Note: Check in with Northwest Airlines
Note: Departs from Terminal A
The following E- Tickets have been issued:
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Northwest Airlines Trip Summary and Receipt 17MAY #OE3ZVQ Page 2 of 3
Passenger Name: HECK/NANCY.S
Receipt Information for your E- Ticket Number(s): 0122179131145
E- Ticket Issue Date: April 27, 2009
Flight Origin- Destination Date Fare Basis Code Status
NW 2194 IND -DCA 17May2009 KA07AOSA Available
NW 2193 DCA -IND 19May2009 KA07AOSA Available
Base Fare: USD184.18 Tax: 14.00
Tax: 13.81 Tax: 7.20
Fare includes fuel surchar a if a plicable. E- Ticket Total:USD219.19
Method of Payment: aria r
Fare Calculation: 7 IND NW WAS92.09NW IND92.09USD 184.18END NW ZPINDDCA XT5.00AY9.00XF
IND4.5DCA4.5
Other Restrictions: NON REFUNDABLE PENALTY FOR CHANGES
Name /Place of Issue: NWA.COM US E- TICKET TAR MPLS /ST PAUL MN/
Passenger Name: LENTZ/MELANIE.J
Receipt Information for your E- Ticket Number(s): 0122179131146
E Ticket Issue Date: April 27, 2009
Flight Origin- Destination Date Fare Basis Code Status
NW 2194 IND -DCA 17May2009 KA07AOSA Available
NW 2193 DCA -IND 19May2009 KA07AOSA Available
Base Fare: USD184.18 Tax: 14.00
Tax: 13.81 Tax: 7.20
Fare includes fuel surcharge if a E- Ticket Total:USD219.19
Method of Payment: almogR n
Fare Calculation: 7 IND NW WAS92.09NW IND92.09USD 184.18END NW ZPINDDCA XT5.00AY9.00 XF
IND4.5DCA4.5
Other Restrictions: NON REFUNDABLE PENALTY FOR CHANGES
Name /Place of Issue: NWA.COM US E- TICKET TAR MPLS /ST PAUL MN/
Add us to Your Address Book Safe Lists: To ensure that your e-mail Trip Summary and Receipt is not
blocked by a filter, please add our "From" e-mail address (webuser @lists.nwa.com) to your address book or
safe list.
Terms and Conditions
CHECK -IN AND BOARDING REQUIREMENTS: Passengers not checked in at least 30 minutes (except Atlanta, Denver, Tampa,
Los Angeles, Washington D.C. Dulles and Newark which require 45 minutes and Las Vegas which requires 60 minutes) and on-
board at least 15 minutes before scheduled departure time for domestic flights; not checked in at least 60 minutes and on -board at
least 30 minutes before scheduled departure time for flights to/from Canada, Mexico, the Caribbean, and all other International
flights may have their pre assigned seat assignment and reserved space canceled and will not be eligible for denied boarding
compensation. Boarding passes may be obtained at nwa.com check -in, at a Northwest Airlines self -service check -in kiosk or any
Northwest check -in position.
Please contact the operating carrier for policy information that may differ from Northwest Airlines.
BAGGAGE: Domestic Coach Class baggage allowance each ticketed passenger is allowed one (1) piece of checked baggage for
a fee of USD$1 5/CAD$1 5 each -way and a second piece of checked baggage for a fee of USD$25 /CAD$25 each -way. A third
piece of baggage will be assessed a fee of USD$125 /CAD$125 each -way and fourth through tenth checked bags will be charged
USD$200 /CAD$200 per bag each -way and subsequent pieces will be assessed a fee of USD$1 00/CAD$1 00 per piece each -way.
For tickets purchased prior to November 12, 2008, the Domestic Coach Class baggage allowance is one (1) piece of checked
baggage for a fee of USD$15 /CAD$15 each -way and a second piece of checked baggage for a fee of USD$25 /CAD$25 each -way.
Third and subsequent pieces will be assessed a fee of USD$1 00/CAD$1 00 per piece each -way. Domestic Coach Class
passengers are also allowed one carry-on, plus a purse, brief case or laptop. First/World Business Class allows three pieces of
checked baggage one carry-on plus a pur se, brief case or laptop. Carry-on baggage must fit underneath the seat or in an
overhead compartment cannot exceed a total linear dimension (length+width +height) of 45 inches. Maximum size per checked
piece is 62 inches. The maximum weight allowance for Coach Class is 50 pounds per piece. First/World Business Class allowance
is 70 pounds per piece. The fee for baggage weighing 51 70 pounds is USD$90 /CAD$90 each -way and for baggage weighing
71 100 pounds is USD$175 /CAD$175 each -way for travel within the US, Canada, Mexico the Caribbean. Excess baggage
charges for travel to intemational destinations vary. Contact Northwest for International excess baggage charges. Any baggage in
excess of the allowance or that is overweight and /or oversize is subject to excess baggage charges.
Regulations require name identification on outside of baggage. Northwest reserves the right to restrict carry-on baggage.
Northwest will not be responsible for money, jewelry, cameras, video and electronic equipment, silverware, negotiable papers,
securities, business documents, samples, paintings, antiques, artifacts, manuscripts, furs, other irreplaceable items or items of
similar value contained in checked or unchecked baggage. Liability for loss, delay or damage to baggage is limited unless a higher
value is declared in advance and additional charges are paid. For travel wholly between US points, baggage liability is limited to
$3,300 per passenger. For most international travel (including domestic portions of international journeys), liability is limited to 1000
SDR.s (Special Drawing Rights) per passenger, for checked baggage and unchecked baggage.
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Northwest Airlines Tnp Summary and Receipt 17MAY #OE3ZVQ Page 3 of 3
DOMESTIC TICKET EXPIRATION: Refundable and Nonrefundable tickets expire one year after date of first departure on ticket.
Once any ticket expires, Northwest will retain all amounts collected from the passenger as an administrative service
charge/cancellation fee.
CHANGES REFUNDS: To make a change to your reservation or to inquire about a refund, if applicable, please visit our website
at www_ nwa_COM. Refer to the fare rules of your ticket for restrictions and limitations. or call nwa.com Website Online Support at
1- 800-692 -6955.
NORTHWEST AIRLINES NOTICE OF INCORPORATED TERMS: Air transportation provided by Northwest Airlines is subject to
the Northwest Airlines Passenger Contract of Carriage, (a.k.a. conditions of contract) the terms of which are hereby incorporated
by reference. Incorporated terms include but are not restricted to: (1) Limits on liability for personal injury or death. (2) Additional
limits on liability for loss, damage, or delay of baggage, including fragile or perishable goods. (3) Claim restrictions, including time
periods in which you must file a claim or sue Northwest. (4) Northwest's rights to change terms of the contract. (5) Rules on
reservations, reconfirmation, check -in times, refusal to carry, and smoking. (6) Northwests rights and limits of liability for delay or
failure to perform service, including schedule changes, substitution of attemate air carriers or aircraft, and rerouting. (7) Fare rules,
including without limitation penalties for changing itinerary or cancellation of your journey on some restricted fares. (8)
Overbooking. If we deny you boarding due to an oversale and you have met all check -in time requirements, with few exceptions,
we compensate you. (9) Northwest reserves the right to refuse carriage to any person who is not able to produce positive
identification. (10) You may inspect the full text of the contract of carriage online at www.nwa,Com or at any Northwest airport.
You may obtain a full copy of the text of Northwest Airlines terms by writing to Northwest Airlines, Inc., Customer Care, P.O. Box
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THI IS A POST -ONLY MAILING. PLEASE DO NOT RESPOND TO THIS MESSAGE.
Northwest Airlines 2009
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T�� 11 ISOR!
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Melanie Lentz Arrival 05 -17 -09
Departure 05 -19 -09
Roost No. 0529
Folio No. 59934
Cashier 1113
INFORMATION INVOICE Page No. I of I
Group Code NATOA
F
Debit Credit
Date Description
05 -17 -09 Ritz Charge -Trns Retail BAR 209.00
05 -17 -09 DC Occ Tar 14.5% 30.31
05 -18 -09 Rat Charge -Trns Retail BAR 209.00
05 -18 -09 DC Occ• Tax 14.5% 30.31
05 -19 -09 Roost Service Breakfast Roottt# 0529: CHECK# 5635 26.76
05 -19 -09 505.38
Balance 0.00
I agree that my liability for this bill is not waived and agree to be personally held liable in the event that the indicated person, company or
association fails• to pay for any part or full amount of these charges. I also agree that all charges contained in this account are correct and
any disputes or request for copies of charges must be made within five days after my departure.
Tint Page 1 of Ncs VW___I0C__2
N oting community interests in communications
IATOA Profile ID #14320 -1014 (Melanie Lentz)
nv ®ice 2009 Spring Conference
Monday, May 18, 2009 $300.00
Keynote Luncheon Meal $0.00
Tuesday, May 19, 2009 $300.00
Luncheon Meal $0.00
Other Extras:
n/a
Total Price: $600
Multi -Day Discount: -100
otal Price (with multi -day discount): $500
ease make checks payable to:
�TOA
0. Box 826127
Liladelphia, PA 19182 -6127
3- 519 -8035
3- 519 -8036 fax
DTE: A Purchase Order does not constitute payment. Payment must be received in full prior to the start of the
)nference.
incellation Policy
iy cancellation prior to Friday, May 1, 2009 will be charged 50% of the total registration fee if cancellation is received
iting at NATOA Headquarters no later than Friday, May 1, 2009. No refunds will be made for cancellations received
:er Friday, May 1, 2009. Substitutions are permitted and encouraged in lieu of cancellation. You may email
.o @natoa.org or fax your cancellation or substitution request to (703) 519 -8036.
.ps:/ /secure. natoa.org/ members Web_ EventRegionaIConference_Helper. php ?action= GENERAT... 4/2/200!
IATOA I, Conferences Events I Annual Conference Page 5 of
Pledse visit www.natoa.or4 to register online. You may pay for your registration by credit card, or you may print off an invoice for processing a
.heck payment. Payments by check must be mailed to P.O. Box 826127, Philadelphia, PA 19182 -6127. Purchase Order does not constitute
Dayment. Payment must be received in full prior to the start of the Conference.
Sponsorship opportunities
4 limited number of Sponsorships are available for those interested in supporting NATOA's Spring Conference. Contact info (cb-natoa.org or cal
103 519 -8035 for more information.
ffiagtaEee• Fam— P.C.
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VS. 8t
the Following Conference Program Details Are Subject To Change
Monday, May 18, 2009
3:00 AM Registration Opens
3:00 AM Continental Breakfast
):00 AM General Session
FRESH PERSPECTIVES BEYOND THE FIRST 100 DAYS
In the first 100 days, we will have seen monumental change in the communications world, but what will it mean going forward?
How will the policies of the Obama administration, Congress' legislative agenda, and a freshly minted slate of commissioners at
the FCC all work to impact the communications landscape? Our panel of experts weighs in on what we can expect to encounter
in the future and how these changes will impact communications at the local government level.
Moderators: Kathleen Waltman I
Speakers: Markham Erickson I Ben Scott I
10:15 AM Refreshment Break
10:30 AM Concurrent Sessions #1
Track: Policy and Legal
CONGRESSIONAL, REGULATORY AND LEGAL UPDATE
An annual tradition, this session focuses on how the federal government has, and will continue, to shape communications law
and policy in 2009 especially with the unprecedented change already seen. How will an overhauled FCC approach policy
matters? What effect will ongoing and pending litigation have on local governments and how they handle communications issues?
How will the obama Administration's own communications priorities impact our communities? This session looks at early
indicators and tries to provide a sense of where the communications world is headed for the rest of 2009.
Moderators: Lay
Speakers: Rick Chessen I Amy Levine I Brian Rice I
Track: Programming
COMMUNICATING IN AN EMERGENCY
Emergency planners increasingly look to a widening range of communications technologies to enable communications with the
public in event of emergency. From targeted text messaging to social networking, reaching the public is a crucial element of
emergency response. And planners are looking anew to old forms of communications —AM radio, cable television, and public
address systems are all part of the toot -kit of reaching the public with critical information. In this session, leaders in emergency
communications will share their strategies and successes in deploying multiple layers and multiple forms of technology to ensure
tp: /natoa.com /events /regional /spring /2009/ 5/12/20(
4ATOA Events I Annual Conference Page 6 of
that their citizens can be reached when necessary.
Moderators: Peterson I
Speakers: David Jordan I Ryan Miller, MS, CE M I Pete Pirineer 1
12:15 PM Keynote Luncheon
KEYNOTE LUNCHEON
Moderators: [tba]
Speakers: [tba]
1:30 PM Concurrent Sessions #2
Track: Policy and Legal
GOVERNMENT 2.0: HOW LOCAL GOVERNMENTS CAN USE WEB 2.0 TOOLS TO MEET GOVERNMENT AND PUBLIC NEEDS
As Web 2.0 transforms how Americans communicate, should government attempt to use Web 2.0 tools to communicate with and
among employees, citizens, and other stakeholders? How can the appeal of social networking, blogs, wikis, user generated
video, and virtual worlds improve government communications and open up a new era in Public, Educational, and Government
Programming (PEG)? And what risks arise from such efforts? Are there security concerns? Privacy? Are the outcomes worth the
investment? This session offers the perspective of leaders in the field of government technology, and points the way to the
future of government communications.
Moderators: Banville I
Speakers: Joaquin Alvarado I Bill Greeves I Todd Sander I
Track: Programming
DIGITAL CINEMATOGRAPHY
How has non linear editing and digital capture changed the way we shoot pieces for PEG? Should we change our ways from the
days of linear edits and tape -based acquisition? Come discover how digital tapeless acquisition and editing can alter your
channel, along with tips for ensuring your content creators can fully utilize the tools at their disposal.
Moderators: Sally Heidrich I
Speakers: Dick Lips I Eric Richardson 1
t:45 PM Refreshment Break
t :15 PM Concurrent Sessions #3
Track: Policy and Legal
21st CENTURY INFRASTRUCTURE: MEETING PUBLIC SAFETY AND OTHER GOVERNMENT NEEDS THROUGH FIBER NETWORKS
Communications networks are the infrastructure of the 21st Century, and America's cities, towns, and counties are increasing
choosing to build their own networks to meet institutional and e- government needs. Private government fiber optic networks,
such as Institutional Networks, enable state -of- the -art services while creating cost and efficiency savings for government,
schools, libraries, and first responders. In this session, three leaders in deploying government fiber networks will discuss how
and why fiber networks are a key part of government communications planning.
Moderators: [tba]
Speakers: Jack Belcher, Ph.D. I Kyle Hollifield I Chris Vein I
Track: Programming
THE STATE OF PEG ACCESS IN 2009
Channels being moved from analog to digital, the Channel 99 product, and channels being taken off the air entirely uncertainty
abounds over what will happen to PEG channel access in 2009. Need answers on what to expect? Sit in as our panel discusses
what's happened, what will happen, and how your channel can be ready to react in the face of change.
Moderators: Beebe I
Speakers: Nantz Rickard I Helen Soule I Joseph Van Eaton. Esq. I
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4ATOA J Conferences Events I Annual Conference Page 7 of
Tuesday, May 19, 2009
8:00 AM Registration Opens
8:00 AM Lobby Day Prep Networking Coffee
Moderators: [tba]
Speakers: Ger Lavery Lederer I John Russell I
9:00 AM Concurrent Session #4
Track: Programming
LOCAL EMERGENCY COMMUNICATIONS AND IT: TRANSPORT £t APPLICATIONS
The FCC has traditionally thought of public safety communications as a wireless/ spectrum issue, but many observers contend
that single focus has led to poor planning and excessive cost. This session takes a different approach, looking at emergency
communications as a range of platforms and applications, including all forms of wired and wireless, public and private
communications, as well as all organizations that are involved in responding to emergencies (public and private). Should
agencies share data over existing fiber pipes (public and private) What role should I -Nets play? Should different agencies and
users work to share communications technologies rather than building stovepiped systems? This session offers an update on new
developments in public safety policy and also offers a broad vision for the future of public safety communications.
Moderators: Nancy Jesuale I
Speakers: David Aylward. EsaEsa. I Robert Gurss I Skip Munster I
Track: Policy and Legal
FRANCHISE RENEWAL KEEPING TECHNOLOGY ON THE FRONT BURNER
Are you beginning to prepare for the renewal of your franchise agreement? What should you do as you prepare for a review of
your current public, education and government access channel equipment, facilities and services? Are you interested in HD
technology or interactive services such as VOD for your residents? Join us as we offer some concrete suggestions for negotiating
your franchise to keep your access channels on the forefront of technology.
Moderators: Zueh lke I
Speakers: Brian Grogan Esa. I Bunnie Riedel I Thomas Robinson I
10:15 AM Refreshment Break
10:30 AM Concurrent Session #5
Track: Policy and Legal
AN INSIDE WASHINGTON VIEW OF HOW TO BENEFIT FROM BROADBAND STIMULUS FUNDS
The new stimulus bill includes an unprecedented $7.2 billion for broadband projects —and specifically contemplates local
community participation. This session features a panel of Washington insiders who will offer their perspectives of the law and
how it is likely to be implemented. Come learn what kinds of projects are likely to be funded, how to plan and prepare
successful grant applications, and how to work with public, non profit, and private partners in your community to maximize your
chances of having your project funded.
Moderators: Meinrath I
Speakers: Lam Atlas I James Bailer I Harold Fel I
Track: Programming
PEG 2.0: Using New Media to Maximize Content
In an online world, presence is everything especially if you want to make the most out of your PEG content. By using social
networking tools, online video applications, podcasting, blogging and more, you can help maximize the reach of your channel
into your community. Discover the ways in which you can enhance visibility, even on a budget, with PEG 2.0 tools.
Moderators: Jacob Colker I
Speakers: Joyce Bounds I Jacob Colker I Michael Hoffman 1
2:15 PM Luncheon
USING STIMULUS FUNDS TO DEMONSTRATE BROADBAND AS AN ECONOMIC DEVELOPMENT AND JOB CREATION TOOL
A key component of the economic stimulus package, broadband infrastructure and connectivity, has the ability to create jobs,
reinvigorate local communities, and provide opportunities once unavailable to citizens. Some communities have already
tp:/ /natoa.com /events /regional /spring /2009/ 5/12/200
NATOAI Conferences Events I Annual Conference Page 8 of
leveraged the transformative power of broadband, so why not yours? Hear how broadband is impacting communities nationwide,
along with how to prepare your community for bringing broadband to bear through a broadband stimulus grant.
Moderators: Karen Archer Perry I
Speakers: Charles Benton I Michael Calabrese I kaeph avaa
1:30 PM Lobby Day on Capitol Hill
&aFeVmm P.C.
Who Should Attend?
City and County Telecommunications Administrators
Elected and Appointed Officials
City and County Managers
City and County Attorneys
Planning and Public Works Directors
Budget and Finance Directors
Cable and Communications Industry Representatives
Government Programmers
Government CIOs and Web site Managers
IT t* Network Managers
P.C.
�un uatiaa� 8c
M=kW JAw Eqprb
'he following is a list of all speakers in alphabetical order.
Alvarado, Joaquin
Director San Francisco State University
Archer Perry, Karen
Director of Community Outreach ft Programs Knight Center of Digital Excellence
Atlas, Larry
Senior Advisor National Telecommunications 8 Information Administration
Aylward, Esq., David
Director and Founder COMCARE Emergency Response Alliance
Baker, James
Senior Principal The Batter Herbst Law Group, P.C.
Banville, Lee
Editor -in -Chief Online NewsHour
Beebe- Kelzie
Tetecomm LA Representative Tammy Baldwin %u2019s Office
Belcher- Ph.D., Jack
Chief Information Officer Arlington County, VA
Benton, Charles
Chairman, CEO £t Trustee The Benton Foundation
p:l /natoa.com /events /regional /spring /2009/ 5/12/200!
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (19flS)
MILEAGE CLAIM M,60LVu 1
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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, I hereby certify that the foregoing account is just and correct, that the amount claimed is le a 1'y ue, after allowing all j t credits
and that no part of t same has been paid.
Date co
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
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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
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Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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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 NO.
oZ ALLOWED 20
Lentz IN SUM OF
';q40 C 1' S-�.
,�IN �Au
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ON ACCOUNT OF APPROPRIATION FOR
-1 U0 xXx
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 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
�I 30
u 20
Sign ture
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund