206977 03/13/2012 F CITY OF CARMEL, INDIANA VENDOR: 027850 Page 1 of 1
ONE CIVIC SQUARE JAMES BRAINARD
CARMEL, INDIANA 46032 CHECK AMOUNT: $54.00
CHECK NUMBER: 206977
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343001 54.00 PARKING
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CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
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EMPLOYEE NAME: James Brainard DEPARTURE DATE: 2/23/12 TIME: 11:10 A /PM
DEPARTMENT: Mayor's Office RETURN DATE: 2/25/12 TIME: 7: 3 0 AM PM
REASON FOR TRAVEL: USCM National Leadership DESTINATION CITY: Jacksonville, Florida
Meeting
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
2/25/12 $54.00 $54.00
$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
$0.00
$0.00
$0.00
0.00
Total $0.00 $0.00 $0.00 $54.00 $0.00 $0.00 $0.00 $0.001 $0.001 $0.00 $0.00
DIRECTOR'S STATEMENT: I hereby a tha II expenses listed conform to the City's travel policy are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form ER06 Revision Date 3/11/2012 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 $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 $32.50 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 $32.50 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:
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 3/11/2012 Page 2
The United States Conference of Mayors
National Leadership Meeting
On Metro Exports and Ports
February 23 -25, 2012
Hyatt Regency Jacksonville Riverfront Hotel
Jacksonville, Florida
REGISTRATION FORM
(You may register on line at http :Ilusmayors.org /J`acksonville]2 or complete this registration form and
fax to U.S. Conference of Mayors Meetings Department at 202 467 4276).
(Any staff who accompanies a Mayor must register separately)
NAME Jim Brainard Title Mayor
Organization City of Carmel, Indiana
Address One Civic Square
City Carmel State IN Zip 46032
Telephone 317- 571 -2401 Fax 317- 844 -3498
Email jbrainardP-carmel. in. gov
Preferred Name on Badge: Mayor Jim Brainard
Name of Partner /Accompanying Spouse: N/A
Attendee has special needs: Yes_ No X (if yes, USCM will contact) 3
HOTEL INFORMATION
A block of rooms has been set aside at the following hotel:
Hyatt Regency Jacksonville Riverfront Hotel
225 East Coastline Drive
Jacksonville, FL 32202
(904) 588 -1234
Single/Double Occupancy
$111 Taxes: 14.13%
IMPORTANT. Room reservations must be made by calling central reservations directly
(1 -888- 421- 1442). Please identify yourself as an attendee of The U.S. Conference of Mayors meeting
to receive the special rate.
Reservations must be confirmed with the hotel by Wednesday, February 15
Reservations must be guaranteed to a credit card for first night's room deposit.
Please return this form to: The U.S. Conference of Mayors
Attention: Carol Edwards
1620 Eye Street, NW, Washington, DC 20006
Telephone: (202) 293 -7330 Fax: (202) 4674276
The United States Conference of Mayors
National Leadership Meeting on Metro Exports and Ports
February 23 -25, 2012
Jacksonville, Florida
Hyatt Regency Jacksonville Riverfront Hotel
Title Sponsor:
SIEMENS
DRAFT AGENDA (As of January 26)
THURSDAY, FEBRUARY 23
6:30 p.m. 8:00 pm. Opening Reception
FRIDAY, FEBRUARY 24
8:00 a.m. 9:00 a.m. Breakfast Available
9:00 a.m. 11:30 a.m. Opening/Working Session Modernizing America's Ports and
Freight Networks
Welcoming Remarks /Moderator:
ALVIN BROWN
Mayor of Jacksonville
Chair, Metro Exports and Ports Task Force
The United States Conference of Mayors
Key topics will include:
U.S. Ports and Global Competition
U.S. Port Modernization
U.S. Ports and Intermodal Transportation
U.S. Freight Corridors
Port Security
11:30 a.m. Press Conference
12:30 p.m. 2:00 p.m. Lunch
Guest Speaker TBA
(Over)
FRIDAY, FEBRUARY 24 (Continued)
2:00 p.m. 4:00 p.m. Working Session Promoting Metro Exports
Moderator:
R.T. RYBAK (Invited)
Mayor of Minneapolis
Vice Chair, Metro Exports and Ports Task Force
The United States Conference of Mayors
Key topics will include:
U.S. Exports and Global Competition
The Jacksonville Export Strategy
Developing Metro Export Strategies
Metro Export Case Studies
6:30 p.m. 9:00 p.m. Reception and Dinner
SATURDAY, FEBRUARY 25
8:30 a.m. 9:30 a.m. Breakfast Available
9:30 a.m.- 12:00 Noon Developing a Global Mayoral Agenda on
Metro Exports and Ports
Presiding: ANTONIO R. VILLARAIGOSA
Mayor of Los Angeles
President
The United States Conference of Mayors
Key topics will include:
Developing a Mayors National Exports Agenda
Mayors Metro Exports Challenge
Developing a Mayors Ports and Freight Agenda
U.S. Conference of Mayors Priorities in the 112`" Congress
The 2012 Presidential Campaign
12:00 Noon Adjourn
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))
02/25/12 Receipt $54.00
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
ALLOWED 20
Mayor Jim Brainard
IN SUM OF
One Civic Square
Carmel, IN 46032
$54.00
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1160 Receipt 43- 430.01 $54.0 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
Sunday, March 11, 2012
Mayo
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund