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Home My WebLink About206977 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 t of CITY OF CARMEL Expense Report (required for all travel expenses) EXHIBIT A �`DIANp 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