178277 10/14/2009 a- CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1
I ONE CIVIC SQUARE !MIKE MCBRIDE
CARMEL, INDIANA 46032 CIO ENGINEERING CHECK AMOUNT: $682.62
CIO ENGINEERING CHECK NUMBER: 178277
«Op C
CHECK DATE: 10114/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4357004 682.62 EXTERNAL INSTRUCT FEE
r
CITY OF CARMEL Expense Report (rewired for all travel expenses)
NDIAHa
.00
EMPLOYEE NAME: Mike McBride DEPARTURE DATE: 10!4!2009 TIME: 7:00am AM PM
DEPARTMENT: Engineering RETURN DATE: 6 -Oct TIME: 4:00pm AM/PM
REASON FOR TRAVEL: IACT DESTINATION CITY: French Lick, IN
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT X PER DIEM X
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
10!6109 $277.50 $277.50
$0.00
1014109 5,60 $55 PO
0
10/5/09 .00 i' .00
10!6109 45 0 5. 0
$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
Totall $0.001 $0.001 $0.001 $0.00 $277.50 $0.001 $0.00 $0.00 $1 .00 $0.001 JA4r5O
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: (�1
City of Carmel Form 4 ER06 Revision Date 10/12/2009 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 $60 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 $60 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: _2' Date: «-O
City of Carmel Form ER06 Revision Date 10/12/2009 Page 2
Prescribed by State Board of Accounts
General Form No. 101 (1955)
n MILEAGE CLAIM
C 1AJ O� N� TO DR.
(Governmental Unit)
�q k &Q-Q V On Account of Appropriation No. 2200) for KO
(Office A�ard, Department or Institution)
DATE FROM TO
ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE OSS
20 Point Point Start Finish TRAVELED PER MILE
b'+- (0 22 M Ly A 269S
t c tti•. S J.
O 12 (a Inn
k 2
M 'AC_
S S b cw ra►vL 2
IF 0 2 r 9 v- 1 2
to to _i 5 AS
Auto License No. TOTALS Z
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 bt \2A0`J /�Y' 6'
Claim 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;
That it is apparently correct
incorrect
On Account of Appropriation No. for
Disbursing Officer
Q C)
Allowed 20
a 0
a'
in the sum of o
(D
(D
5��
(D
FD
(D
m
o 0
(Board or Commission)
(D
FILED
C1 N
a
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c�
(Official Title)
O
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O C R.
TRAVEL /EXPENSE
REIMBURSEMENTS
For: Sept. 2009
Milea a to Milea a Back Parking Other Total Miles Total
Date Meeting Description Start Finish Start Finish Cost Costs Other Description Miles x $.55 Expense
9/2/2009 INDOT LPA Guide -QAC Meeting (IGC North) 6673 6722 $0.00 $0.00 49 $26.95 $26.95
9/14/2009 96th Keystone Mtg. with Enterprise (96th 6942 6955 $0.00 $0.00 13 $7.15 $7.15
Priority Way)
9/17/2009 Keystone Meeting (American Structurepoint) 7058 7070 $0.00 $0.00 12 $6.60 $6.60
9/21/2009 US31 Roundabout Interchange Analysis 7201 7213 $0.00 $0.00 12 $6.60 $6.60
Meeting (Structurepoint Offices)
10/1/2009 Keystone Meeting (American Structurepoint) 7444 7456 $0.00 $0.00 12 $6.60 $6.60
10/1/2009 Meeting Parsons Transpo then W/ INDOT 7456 7503 $0.00 $0.00 47 $25.85 $25.85
US31 Desige Team (IGC North)
10/2/2009 Mtg. with Cripe Re: Coxhall Park (96th 1 -69 7526 7541 $0.00 $0.00 15 $8.25 $8.25
Bob Evans)
10/4/2009- IACT Conference (French Lick, IN) 7574 7851 $0.00 $0.00 277 $152.35 $152.35
10/06/2009
$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
$0.00 $0.00 $0.00 $0.00
1 $0.00 $0.00 $0.00 $0.00
Refund Total $240.35
WEST BADEN SPRINGS
H O T E L
Name: MIKE MC BRIDE Arrival Date: 10/04/09 Cl Clerk DNELSON
Address: 300 S MARIDIAN ST Departure Date: 10/06/09 CO Clerk NHART
INDIANAPOLIS IN 46225 Group Code: FLIACT
Room`:# WB 4430 Resv 399951794421 °Page' 1 of 1
Date Reference Description Charges Credits
10/04/09 400899000513 ROOM CHARGE WB 4430 125.00
TAX1 8.75
TAX2 5.00
10/05/09 400909000565 ROOM CHARGE WB 4430 125.00
TAX 1 8.75
TAX2 5.00
10/06/09 400912728062 WB FRONT DESK
Total Due .00
I agree to remain personally liable for the payment of this account if the corporation or other third party
fails to pay part or all of these charges. I also agree that all charges contained in this account are correct
and any disputes or requests for copies of charges must be made within five (5) days after my departure.
If you are using a credit card, the hold may last up to 3 business days past your check -out date. If you
are using a debit card, the hold on funds may last from 7 -10 business days after your check -out date.
Guest Signature:
Page] of 2
McBride, Mike T
From: jmuehlfeld @citiesandtowns.org
Sent: Thursday, September 03, 2009 1:03 PM
To: McBride, Mike T
Subject: Conference Registration CONF9891251997399
To: "Michel McBride" mmcbride @carmel.in.
From: jmueh(fetd@citiesandtowns.org
Subject: Conference Registration
Date: 2009 -09 -03 13:03:18
Tracking CONF9891251997399
Thank you for registering for the TACT Annual Conference 8t Exhibition.
Please print a copy of this page for your records; this will serve as your receipt. There is a printer friendly
option on the upper right -hand side of the page.
If you selected the "Invoice Me" option, please print off this page as your invoice and mail your check,
made payable to IACT, to the address below.
If you require special arrangements we will do our best to accommodate you.
Cancellation Policy
Written cancellations received on or before September 25, will be refunded less a $40 processing fee. Only
written cancellations will be accepted. Please mail your written cancellation to 200 S. Meridian St., Suite 340,
Indianapolis, IN 46225, Attn: Lindsay Heinzman; fax to (317) 237 -6206 or send to
lheinzman @ci tiesandtowns. or
IACT is not responsible for hotel reservations or cancellations.
Send Payment To:
Indiana Association of Cities Et Towns
200 South Meridian Street, Suite 340
Indianapolis, IN 46225
Transaction Summary
Item Cost Qty Total
Contact Information
First Name: Michel
Last Name: McBride
Municipality /Company: City of Carmel
Telephone: (317)571 -2441
Address: One Civic Square
City: Carmel
10/8/2009
Page 2 of 2
State: IN
ZIP Code: 46032
Conference Registration Form
1 Registration Type: 135 135.00 1 135.00
First Name: Michael
Last Name: McBride
Title: City Engineer
Municipality /Company: City of Carmel
Address: One Civic Square
City: Carmel
State: IN
ZIP Code: 46032
Telephone: (317)571 -2441
Email: mmcbride @carmel.in.gov
First time attending IACT Annual Conference
Exhibition?: 'No'
Sunday Welcome Party: 'No'
Monday Nelson Steele Memorial Run /Walk: 'No'
Monday Opening Business Session and Continental
Breakfast: 'No'
Monday Annual Awards Luncheon: 'No'
Tuesday Breakfast in Exhibit Hall: 'No'
Tuesday Lunch in Exhibit Hall: 'No'
Tuesday Closing Business Session: 'No'
Tuesday Presidents Reception Annual Banquet: 'No'
Wednesday Closing Breakfast: 'No'
Golf at Donald Ross: 'No'
Sub -total 1 135.00
Shipping /Handling /Access Fee 0.00 0.00
Total Cost 135.00
Billing Contact
Michel McBride
City of Carmel
One Civic Square
Carmel, IN 46032
mmcbrideCcarmet.in.gov
10/8/2009
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Mike McBride
Purchase Order No.
Engineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
nla n1a IACT conference expenses 42.50
nla Mileage September -Oct 6th 40.35
08/31/09 Keystone Mtg Jimmy John's 14.77
Total
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
Mike McBride IN SUM OF
Engineering Department
$;p 62
W .0
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT p I hereby certify that the attached invoice(s), or
n/a 10/06/09 2200 435700 M bills) is (are) true and correct and that the
9/2 10/06 2200 4357004 $240.35 materials or services itemized thereon for
08/31/09 22004357004 1477 which charge is made were ordered and
received except
10nn1'Z.L p� 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund