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Home My WebLink About171088 04/16/2009 w ci�4 CITY OF CARMEL, INDIANA VENDOR: 00350084 Page 1 of 1 e ONE CIVIC SQUARE TOM SMALL CHECK AMOUNT: $1,268.92 CARMEL, INDIANA 46032 201 COTTONWOOD DR ANDERSON IN 46012 CHECK NUMBER: 171088 CHECK DATE: 4116/2009 DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 1,268.92 EXTERNAL 'TRAINING TRA �j�JOF CAq� CITY OF CARMEL Expense Report (required for all travel expenses) `�N010.NP EMPLOYEE NAME: DEPARTURE DATE TIME: AM PM DEPARTMENT: RETURN DATE: s -SZ)°, TIME: AM PM REASON F O R T RAVEL:` 5�_" DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVAN9 TRAVEL REIMBURSEMENT TRAVEL PER DIEM Date Transportation GaslTolls/ Lodging Meals Misc. Total Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem $0.00 3125109 $65.00 $65.00 3126109 $65.00 $65.00 3/27109 $65.00 $65.00 3128109 $65.00 $65.00 3129109 $943.92 $65.00 $1,008.92 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0. $0.00 $0.00 $o.00 $0.00 $0.00 0.00 Total $0.00 $0.00 $0.00 $0.00 $943.92 $0.00 $0.001 $0.001 $0.001 $325.001 $0.00 DIRECTOR'S STATEMENT: I to the City`s_ travel policy and are within my.. department's appropriated budget. Director Signature: Date: City of Carmel Form ER06 Revision Date 4!9/2009 Page 1 401 W. Pratt Street Baltimore, MD 21201 Phone(443)573 -8700 Fax(443)683 -8841 Hil ton Reservations Name Address Baltimore w ww.baltimore.hilton.com or 1 800 HILTONS SMALL, THOMAS Room 1058/K1RV Arrival Date 3/2512009 9:44:OOAM Departure Date3/29/2009 Adult /Child 110 Room Hate 185.00 L RATE PLAN C -EMS c J H H# AL: BONUS AL: CAR: CONFIRMATION NUMBER 3335504558 3/2912009 PAGE 1 DATE DESCRIPTION ID REF. NO CHARGES CREDITS BALANCE 3/25/2009 SELF PARKING SCLAPP 260824 $26.00 3/25/2009 GUEST ROOM SCLAPP 260825 $185.00 TheHiltonFamily 3125/2009 CITY TAX (R) SCLAPP 260825 $13.88 3/25/2009 STATE TAX (R) SCLAPP 260825 $11.10 3/26/2009 SELF PARKING SCAGER 262919 $26.00 `R) 3126/2009 GUEST ROOM SCAGER 262920 $185.00 FIilton 3/26/2009 CITY TAX (R) SCAGER 262920 $13.88 3/26/2009 STATE TAX (R) SCAGER 262920 $11.10 3/27/2009 SELF PARKING FBAH 264933 $26.00 coNRAD 3/27/2009 GUEST ROOM FBAH 264934 $185.00 3/27/2009 CITY TAX (R) FBAH 264934 $13.88 3/27/2009 STATE TAX (R) FBAH 264934 $11.10 3/28/2009 SELF PARKING FBAH 267089 $26.00 DOD e LIT- 3/2812009 GUEST ROOM FBAH 267090 $185.00,, 3/28/2009 CITY TAX (R) FBAH 267090 $13.88 3/28/2009 T AX (R) FBAH 267090 $11.10 312912009 LJUMPER 267895 $943.92 BALANCE $0.00 L M illon ardenlnn Hill'! Grand Vacations Club ACCOUNT N0. DATE OF CHARGE POL!0 NO.1 HECK NO. 83515 A +w HOMEWOOD Sl= Hit-- CARD MEMBER NAME AUTHORIZATION INITIAL FSTABLISHMENT NO. &LOCATION I- WAIII.ISHen!N P-RCs TD TR ramj 11) CARD HOLDER FUR PAYMENT PURCHASES SERVICES ^p� ^pp�� U W- TAXES Official 5pomor TIPS MISC. CARD MEMBER'S SIGNATURE X TOTAL AMOUNT MERCHANDISE ANDIOR SERVICES PURCHASED ON THIS CARD SHALL, NOT BE RESOLD OR RETURNED FOR A CASH REFUND- PAVMFNT DUF. UPON RECEIPT Res istrabon Confirmation Page. 2 of 2 INVOICE Invoice 208303 Invoice Date: 3/1212009 Terms: Due u pon recei Bill to: Remit to: CARMEL FIRE DEPT EMS Today Conference and Attn: TOM SMALL Exposition 2009 2 CIVIC SQ, 350 E. Royal Lane, Suite 100 CARMEL, IN, 46032 Irving, TX 75039 -3105 Attn: Accounts Receivable Inv-aice for E Today G and Exposition 2009 YOUR Purchase Order Number: TOM SMALL 208303 TOM SMALL CARMEL FIRE DEPT Description Qty Unit Price Amount PEND!NC'PAYMENT .1 $0.00 $0.00 Silver Passport .1 $375.00 $375.00 Speed Networking 1 $37.00 $37.00 Anal zin Your EMS System Effectively 1 $4.00 $0.00 Lightning Round: Legal Issues in EMS 1 $0.00. $0.00 Issues of.O erational'Staffin Deployment. and Response for EMS Agencies 1 $0.00 $0.00 Fire -Based EMS: The Issues, the Ctiallen es 1 $0.00 $0.00 They Shoot EMS Managers Don't They! 1 $0.00 $0.00 The Hallmarks of a Quality EMS System 1 $0.00 $0.00 PLEASE Remit this Amount $41200 Our Federal ID 52- 1471842 Make Check Payable to "Reed Exhibitions" Remit to: EMS Today Conference and Exposition 2009 350 E. Royal Lane Suite 100 Irving, TX 75039 -3105 Attn: Accounts Receivable haps: /web I .accureg. cony /ems09_prod/ConfLetter /Con fl. asp?UserName= guest &DisplayLetter =P... 3/12/2009 PRIORITY CODE: WEB J I am eligible for the New Jersey EMT Training Fund Yes, I am a member of the American Ambulance Association Please type /print name and title as you wish them to appear on your name badge: U Do you have any special needs? Please check here and our staff will contact you. FIRST NAME Please check off the events and workshops you will be attending: Ot"�\ Tuesday, March 24, 2009 LAST NAME \o`�� One -Day Preconference Workshops 8:00 a.m. 5:00 p.m. U (0001) Advanced Airway Course (Classroom Cadaver Lab) (Limit of 42) TITLE \,2" U (0002) EMS Command School: Hands -On Reality -Based Command Training (Limit of 25) 1 Wednesday, March 25, 2009 ORGANIZATION S\C e One -Day Preconference Workshops 8:00 a.m. 5:00 p.m. C IJ (0003) Advanced Airway Course (Classroom Cadaver Lab) (Limit of 42) ADDRESS �w J�� U (0004) EMS Command School: Hands -On Reality -Based Command Training (Limit of 25) U (0005) Trauma from A to Z This address is my Home lit<ffice U (0006) Train the Trainer: OSHA Bloodborne Pathogens Tuberculosis (Limit of 50) IJ (0007) Multi -Lead Medics: 12 -Lead ECG Interpretation CITY STATE ZIP��a��c� Wednesday, March 25, 2009 COUNTRY Half -Day Preconference Workshop 6:00 a.m. 12:00 p.m. (0008) Leadership Essentials for EMS Managers (0009) Discipline With Due Process: New Challenges Confronting Your Service PHONE 7.'��-�O FAX 5�� a�o� (0010) ALS Assessment Workshop: Tips to Assist You in Assessing Managing Complex Cases This phone is my G Hom U Office Wednesday, March 25, 2009 E -MAIL ADDRESS: a- �Q to c m�� h �Z-'i�J Half -Day Preconference Workshop 1:00 p.m. 5:00 p.m. A UNIQUE EMAIL ADDRESS IS REQUIRED —YOUR CONFIRMATION SENT -VIA U (0011)Test Development: Guidelines to Take Your Tests from Failing to Fabulous EMAIL. EMAIL ADDRESS NEEDED FOR CEU CERTIFICATE LOGON. CJ (0012) Issues and Innovations in EMS Systems U (0013) Issues in Volunteer EMS Management U YES, I WANT A CEU CERTIFICATE Early Regular By Fete 20 After Feb. 20 CERTIFICATION/ LICENSE U 1 -Day Workshops 0001 -0004 $230 $270 Please check your selection above LICENSE STATE DATE OF BIRTH Li 1 -Day Workshops 0005 -0007 $195 $225 Please check your selection above U 1/2 -Day Preconference Workshops $100 $135 LEVEL OF LICENSURE /TYPE OF LICENSE Please check your selection above U Ali LICENSE EXPIRATION DATE U BLS Subscription to JEMS A 6 -month subscription to JEMS is included in your registration fee. IF YOU HAVE MULTIPLE CERTIFICATIONS, PLEASE FAX OR EMAIL THEM WITH YOUR FIRST U Check here if you do not wish to recieve JEMS. AND LAST NAME TO: 972/620 -3099 OR INQUIRY @EMSTODAYEXPO.COM Conference Fees (please check one) PLEASE CIRCLE THE NUMBERS OF THE MAIN SESSIONS YOU PLAN TO ATTEND: Early Regular Wednesday, March 25, 2009 —Speed Networking (Limited to 100, add'I $37) and Evening Sessions $4 Feb. -N After Feb. 1-1 Gold Passport 3 -Day $415 $495 1000 1001 1002 1003 1004 1005 1006 1007 1008 1 crudes Wednesday Evening Sessions Thursday, March 26, 2009— Keynote and Morning Sessions I{d'Silver Passport 2 -Day $305 $375 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Includes Wednesday Evening Sessions Thursday, March 26, 2009 —Lunch Learns (Limited to 25 each, add'I $26) U Wednesday Evening Sessions $50 $50 One -Day Only $190 $265 L001 L002 L003 L004 L005 L006 (FREE Luncheon to first 105 attendees) IJ Exhibit Hall Only Pass $10 $20 2013 Prehospital Care Research Forum Session Only (If you register for the conference your exhibit pass is included) Thursday, March 26, 2009 —Early Afternoon Sessions C uest Pass to Exhibits Only $10 $20 3001 3002 3003 3004 3005 3006 3007 3008 3009 Peed Networking $37 $37 IJ Lunch &Learn $26 $26 Thursday, March 26, 2009 —Late Afternoon Sessions (Available to paid conference registrants only: 1, 2 or 3 -day) 4000 4001 4002 4003 4004 4005 4006 4007 4008 4009 4010 Friday, March 27, 2009 Morning Sessions Please circle which days you will attend the main conference: Thursday Friday Saturday 5001 5002 5003 5004 5005 5006 5007 5008 5009 5010 A Conference/ Exhibit Hall Registration Fee Friday, March 27, 2009 —Early Afternoon Sessions B Preconference Workshop(s) 6001 6002 6003 6004 6005 6006 6007 6008 6009 6010 C Six -month Subscription to JEMS ($21 value) INCLUDED Friday, March 27, 2009 —Late Afternoon Sessions D Group Discou $5 (Good o 2-day or 3 day only.) 7001 7002 7003 7004 7005 7006 7007 Group- $500 OR $1,000 Saturday, March 28, 2009 Keynote and Early Afternoon Sessions Military $100 (Please fax /mail a copy of your Military to with your reg. form) 8000 8001 8002 8003 8004 8005 8006 8007 8008 8009 8010 8011 8012 (See page 9 for discount information.) Saturday, March 28, 2009 —Late Afternoon Sessions TOTAL AMOUNT ENCLOSED O 9001 9002 Payment Information: 1. CUPATION /POSITION 2. EMPLOYER /AFFILIATION closed is my check for payable in U.S. dollars to Reed Exhibitions. A PARAMEDIC /EMT -I /EMT -D !J 1. HOSPITAL Enclosed is my Purchase Order N for U 2. PRIVATE AMBULANCE Charge my: 0 VISA IJ MasterCard U AMEX Li B. EMT (BASIC, 1ST RESPONDER) 3. FIRE DEPT. /RESCUE SQUAD U C. NURSE /INSTRUCTOR /COORDINATOR U 4. THIRD SERVICE /MUNICIPAL AGENCY Account# U D. PHYSICIAN IJ 5. INDUSTRIAL /COMMERCIAL p E. ADMINISTRATOR/SUPERVISOR, fJ 6. EDUCATIONAL INSTITUTION Exp. Date 7. MILITARY EMS CHIEF, FIRE CHIEF OTHER CHIEF Li 8. OTHER Card Holder COMPANY OFFICER U 9.VOLUNTEER F. MILITARY 3. PURCHASING ROLE Authorized Cardholder Signature G. STUDENT (Chp ck all that apply) Q 0. OTHER IXFA PURCHASE PRIVACY POLICY I ill'yB APPROVE We collect data to provide you with information about EMS Today Conference L' FC RECOMMEND Exposition and other companies in your industry. If you prefer not to receive further U FD SPECIFY information. please see our Privacy Statement at www.EMSTodayConference.com or O FE INFLUENCE call our Privacy Administrator at 1- 888 306 -2344 or 1- 203 -840 -5810. March 24 -28, 2009 Baltimore, MID 33 Page I of 2 Snyder, Denise W From: Debbie Tunstill Debbie. Tunstill @thetravelagentinc.com] Sent: Friday, March 13, 2009 3:34 PM To: Snyder, Denise W Subject: Confirmed Flight for Thomas Small SALES PERSON: DT2 ITINERARY /INVOICE NO. ITIN DATE: MAR 13 2009 ACCOUNT W1 LN4G PAGE: 01 FOR: SMALL /THOMAS TO: CITY OF CARMEL CITY OF CARMEL -FIRE DEPT ONE CIVIC SQUARE 3RD FLOOR ATTN: DENISE SNYDER CARMEL IN 46032 TWO CIVIC SQUARE CARMEL IN 46032 25 MAR 09 WEDNESDAY MILES- 515 ELAPSED TIME- 1:30 AIR LV INDIANAPOLIS 710A SOUTHWEST FLT:3405 COACH CLASS CONFIRMED AR BALTIMORE 840A NONSTOP SOUTWEST CONF JXK5QU 29 MAR 09 SUNDAY MILES- 515 ELAPSED TIME- 1:50 AIR LV BALTIMORE 415P SOUTHWEST FLT:1025 SPCL CLASS CONFIRMED AR INDIANAPOLIS 605P NONSTOP SOUTHWEST CONF JXK5QU THIS IS AN ELECTRONIC TICKET. PLEASE PRESENT PHOTO ID AT CHECK IN WITH CONF. TICKET IS COMPLETELY NONREFUNDABLE IF UNUSED. MAY CHANGE ONLY PRIOR TO ORIGINAL TRAVEL DATE. FEES WILL APPLY. "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..DEBBIE WWW.TTA.TRAVEL AIR TRANSPORTATION 228.84 TAX 38.36 TTL 267.20 PROCESSING FEE 35.00 SUB TOTAL 302.20 CREDIT CARD PAYMENT 302.20 TOTAL AMOUNT 0.00 1/9/2009 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)) Per Diem Lodging $1,268.92 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. ALLOWED 20 Tom Small IN SUM OF $1,268.92 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 43- 430.02 $1,268.92 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 APR 13- 7-0-0-9- t n v Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund