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HomeMy WebLinkAbout174195 07/07/2009 CITY OF CARMEL, INDIANA VENDOR: 080501 Page 1 of 1 ONE CIVIC SQUARE CINDY SHEEKS CHECK AMOUNT: $1,172.62 CARMEL, INDIANA 46032 13791 LAREDO DRIVE CARMEL IN 46032 CHECK NUMBER: 174195 CHECK DATE: 7/7/2009 DEPAR TMENT ACCOUNT PO NU MBE R IN VOICE N UMBER AMOUNT DES 1701 r 4343004 36.30 MILEAGE 1701 4343004 108.32 TRAVEL PER DIEMS 1701 R4343004 18293 1,028.00 LODGING -GFOA CONFEREN Prescribed by State Board of Accounts General Form No. 101 (1955) L A 4 M ILEAGE CLAIM TO DR. (G rnmental Unit) Y On Account of Appropriation No. `f /f or (Office, Board, Department or Institution) DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE S� 20 Point Point Start Finish TRAVELED PER MILE 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 Clam No. Warrant No. I have examined the within claim and 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; corrct That it is apparently I incorrect On Accou of Appropriation No "J(� a-J for Disbursing Officer O O Allowed 20 e o t3' in the sum of a N Q (D �y C) a Vim( O O 0 E (Board or Coinn fission) (D (D FILED m D1 a (D Q N (D 0 ch Cn U) (Official Title) (D O O (D Q F CggM gyp CITY OF CARMEL Expense Report (required for all travel expenses) M M N EXHIBIT A EMPLOYEE NAME: (l ��CINDY SHEEKS DEPARTURE DATE: �IZ� G� TIME: i AM DEPARTMENT. RETURN DATE. I a` 1 TIME: 10 AM M REASON FOR TRAVEL: _GFOA DESTINATION CITY: SEATTLE EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date p Luggage Parkin Lodging Misc. Total Taxi Tips Lu a e g Breakfast Lunch Dinner Snacks Per Diem 6/27/09 $40.00 $145.58 $65.00 $250.58 6/28/09 $145.58 $65.00 $210.58 6/29/09 $4.00 $145.58 1 $65.00 $214.58 6/30/09 $145.58 $65.00 $210.58 7/1/09 $55.00 $40.00 $90.00 $65.00 $250.00 $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 L $0.00 0.00 Total $55.00 $0.001 $80.00 $94.00 $582.32 $0-1501 $0.001 $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 7/7/2009 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: l City of Carmel Form ER06 Revision Date 7/7/2009 Page 2 13016th Avenue Seattle WA 98101 u7 fl 1 Phone (206) 624 -0500 Fax (206) 682 -9029 l� Reservations Name 8 Address Seat le www.seattlehilton.com or] 800 HILTONS SHEEKS, CINDY Room 1414/K1S Arrival Date 6/27/2009 5:12:OOPM Departure Date 7/1/2009 Adult/Child 1/0 Room Rate 180.00 RATE PLAN C -GFOA HH# 223338544 BLUE AL BONUSAL CAR Confirmation Number: 3346111118(/ 7/1/2009 PAGE 1 a DATE DESCRIPTION ID REF. NO CHARGES CREDITS BALANCE 6/15/2009 CHECK (NUMBER 166882) CRT 1399586 $250.00 6/27/2009 GUEST ROOM JSN 1409898 $180.00 6/27/2009 ROOM TAXES JSN 1409898 $28.08 6/28/2009 GUEST ROOM DAW 1410741 $180.00 6/28/2009 ROOM TAXES DAW 1410741 $28.08 6/29/2009 GUEST ROOM APA 1411528 $180.00 6/29/2009 ROOM TAXES APA 1411528 $28.08 6/30/2009 GUEST ROOM APA 1412299 $180.00 6/30/2009 ROOM TAXES APA 1412299 $28.08 WILL BE SETTLED TO $582.32 EFFECTIVE BALANCE OF $0.00 You have earned approxir 7 ately 7200 Hl l onors poir is and approximate) 720 miles with Northwest irlines for thi stay. To c eck your earnings r this stay or any other stay at any of more than 3, 000 Hi I Thank you for choosing H ton! Book yot, r next stay at hilton.com and tae 0 advantage of our internet my Advance urchase Rates and limited -tim special offers! DATE OF CHARGE FOLIO NO. /CHECK NO. 261218 A Zip -Out Check -Out y Good Morning! We hope you enjoy your stay. With Zip -Out Cheek -Out AUTHORIZATION INITIAL there is no need to stop at the Front Desk to check out. Please review this statement. It is a record of your charges as of late last PURCHASES SERVICES evening. For any charges after your account was prepared, you may: TAXES 0 pay at the time of purchase. charge purchases to your account, then stop by the Front Desk for an updated statement. TIPS MISC. or request an updated statement be mailed to you within two business days. Simply call the Front Desk from your room and tell us when you are ready to TOTAL AMOUNT depart. Your account will be automatically checked out and you may use this statement as your receipt. Feel free to leave your key(s) in the room. Please call the Front Desk if you wish to extend your stay or if you have any questions about your account Northwest Airlines nwa.com Travel Center Page 1 of 2 �v 1` Reservation Details g Send to Printer *N67Q5F* Below are the flight and E- Ticket details for your confirmed reservation. I Confirmation N67Q5F NWA Number: Passenger Name E- Ticket Number Frequent Flyer Number SHEEKS /CYNTHIA 0127531227825 NW100905951484 The following flights are confir 19 days until depar Date: Saturday, June 27 J Flight: NW 497 Departs: Indianapolis- Int'I, IN (IND) at 11:52AM Arrives: Minneapolis /St. Paul- Int'I, MN (MSP) at 12:38PM Class of Service: Economy Class (K) Seat: 11 -A Window Flight Duration: 1 hour 46 minutes Approximate Miles: 502 Meal Service: None Aircraft: McDonnell Douglas DC9 -50 Note: Flight Status posted day before departure Note: Operated by Northwest Airlines Note: Check in with Northwest Delta Air Lines Date: Saturday, June 27 Flight: NW 627 Departs: Minneapolis /St. Paul Int'l, MN (MSP) at 2:15PM Arrives: Seattle/Tacoma Int'I, WA (SEA) at 3:54PM Class of Service: Economy Class (T) Seat: 31 -C Aisle Flight Duration: 3 hours 39 minutes Approximate Miles: 1,395 Meal Service: Sandwich and Snacks for sale Aircraft: Boeing 757 -300 Note: Flight Status posted day before departure Note: Operated by Northwest Airlines Date: Wednesday, July 1 Flight: NW 170 Departs: Seattle/Tacoma Int'l, WA (SEA) at 12:10PM Arrives: Minneapolis /St. Paul- Int'I, MN (MSP) at 5:29PM Class of Service: Economy Class (V) Seat: 29 -D Aisle Flight Duration: 3 hours 19 minutes Approximate Miles: 1,395 Meal Service: Sandwich and Snacks for sale Aircraft: Boeing 757 -300 Note: Flight Status posted day before departure Note: Operated by Northwest Airlines Note: Check in with Northwest Delta Air Lines Date: Wednesday, July 1 Flight: NW 122 Departs: Minneapolis /St. Paul- Int'I, MN (MSP) at 7:15PM n 1 7 Arrives: Indianapolis- Int'I, IN (IND) at 9:59PM Class of Service: Economy Class (V) Seat: 16 -D Aisle Flight Duration: 1 hour 44 minutes Approximate Miles: 502 Meal Service: None Aircraft: Airbus A320 Note: Flight Status posted day before departure Note: Operated by Northwest Airlines Notes: Some flights may be operated by our alliance partner, KLM Royal Dutch Airlines, Northwest designated affiliate partners, or Northwest Airlink. Times shown are local times at the departure /arrival cities. https: /www.nwa.com/cgi- bin /view_res.pro ?param= A0570C845C27C939A 105D768FCED040399... 6/8/2009 \1 THE TRAVEL AGENT tel 317846.9619 800.347.2512 �n��Jo- ix��l- fim�eC a��alirid fax 317848.3998 I'scablished 1979. email infoC3thetravelagent.travel web. www.thetravelagent.travel lcruo tiO M l x'I B I R. 11562 Westfield Boulevard Carmel, Indiana 46032 a= =a t= SALES PERSON: A09MV ITINERARY /INVOICE NO. 53780 DATE: MAR 04 2009 ACCOUNT CPD RFFS2E PAGE: 01 FOR: SHEEKS /CYNTHIA TO: CITY OF CARMEL CITY OF CARMEL ONE CIVIC SQUARE 3RD FLOOR ONE CIVIC SQUARE 3RD FLOOR CARMEL IN 46032 CARMEL IN 46032 27 JUN 09 SATURDAY MILES— 503 ELAPSED TIME— 1:50 AIR LV INDIANAPOLIS 1250P NORTHWST AIR FLT: 497 ECONOMY CONFIRMED AR MPLS /ST PAUL 140P NONSTOP FREQ FLYER NW 100905951484 AIRLINE CONFIRMATION:NW N67Q5F MILES— 1399 ELAPSED TIME— 3:36 AIR LV MPLS /ST PAUL 230P NORTHWST AIR FLT: 627 COACH CLASS CONFIRMED AR SEATTLE 406P NONSTOP FREQ FLYER NW 100905951484 AIRLINE CONFIRMATION:NW N67Q5F 01 JUL 09 WEDNESDAY MILES- 1399 ELAPSED TIME- 3:16 AIR LV SEATTLE 1210P NORTHWST AIR FLT: 170 COACH CLASS CONFIRMED AR MPLS /ST PAUL 526P NONSTOP FREQ FLYER NW 100905951484 AIRLINE CONFIRMATION:NW N67Q5F MILES— 503 ELAPSED TIME— 1:42 AIR LV MPLS /ST PAUL 652P NORTHWST AIR FLT: 496 COACH CLASS CONFIRMED AR IIVUTANAPOLIS 934P NONSTOP FREQ FLYER NW 100905951484 AIRLINE CONFIRMATION:NW N67Q5F "YOU MUST VERIFY ALL INFORMATION IS CORRECT. ONCE ISSUED FEES AND PENALTIES EXIST FOR REISSUES REFUNDS CHANGES. FOR AFTER HOURS EMERGENCIES ON EXISTING RESERVATIONS CALL 877 6456373 CODE A09. $15.00 PER CALL FEE WILL BE CHARGED A CANCELLATION FEE OF 10PCT ON TTL COST OF BOOKED TOURS— CRUISES LAND HOTEL PKGS WILL APPLY. AIRLINE CHECKED BAGGAGE NOTICE FOR DOMESTIC AND INTERNATIONAL TRAVEL AIRLINES MAY CHARGE THE TRAVEL AGENT THANKS YOU -317 846 9619..MARIANNE..WWW.TTA.TRAVEL AS YOUR TRAVEL ADVISOR, WE RECOMMEND YOU ALWAYS PURCHASE INSURANCE FOR ALL TRAVEL COMPONENTS. TRAVELEX INSURANCE SERVICES IS OUR PREFERRED PROVIDER.. FOR TERMS AND CONDITIONS, REFER TO: WWW.TTA.TRAVELlrERMS ��TT�� tel 317.846.9619 800.347.2512 S A �E rr AEL RAI4Y INVO I C& N9317848.399853780 DATE •MAR 04 2 �PtJ2Cv, f2CZIlle `A'(�t7NT C PD F c F PAGE:, 02 ftitahlishi 1 1979. email infopthetrabtlygt�.t avel FOR. web www.thetravelagent.travel J SHEEKS304M II I IAlevard I Carmel, Indiana 46032 I It l UOSO 1 I \I 131: R. CITY OF CARMEL CITY OF CARMEL ONE CIVIC SQUARE 3RD FLOOR ONE CIVIC SQUARE 3RD FLOOR CARMEL IN 46032 CARMEL IN 46032 TICKET NUMBER /S: SHEEKS /CYNTHIA 7531227825 CARD 575.91 ELECTRONIC AIR TRANSPORTATION 496.28 TAX 79.63 TTL 575.91 PROCESSING FEE 35.00 SUB TOTAL 610.91 CREDIT CARD PAYMENT 610.91 TOTAL AMOUNT 0.00 ASYOURTRAVEL ADVISOR, WE RECOMMEND YOU ALWAYS PURCHASE INSURANCE FOR ALLTRAVEL COMPONENTS, TRAVELEX INSURANCE SERVICES IS OUR PREFERRED PROVIDER.. FORTERMS AND CONDITIONS, REFERTO: WWW.TTA.TRAVEUTERMS Seattle Expenses to be reimbursed Credit Card non Non Cash Cash Credit Card reimburse Mileage 35.75 Cab to airport 55.00 Bag fees 80.00 Monorail 4.00 Per Diem 325.00 Dinner at Capital Grille 50.00 Macy's 224.58 Ride the Ducks 54.76 Parking 90.00 Hotel 582.32 360.75 59.00 752.32 1,172.07 329.34 1,081.66 put on credit card G ©�ernm Finance Officers Association 103rd Annual Conference Fi nancial Strategies foW C'b lle;ngfng Tides Proyr�m Guide G�� ®firma Se�:�ttle, W�.�sf�inc� ton Jung 2: July 1 2009 1 Important Phone Numbers to Remember Message Center (206) 219 -4657 Registration (206) 219 -4654 Staff Office (206) 219 -4650 V Prescribed by State Board of Accounts City Form No. 291 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CAR•MEL 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)) Total 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 v L IN SUM OF ON ACCOUNT OF APPROPRIATION FOR �kn 7VZL,4j� Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT I hereby certify that the attached invoice(s), or 4 '30 D* (029, bill(s) is (are) true and correct and that the materials or services itemized thereon for _r which charge is made were ordered and received except A�L 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund