168806 02/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1
0 ONE CIVIC SQUARE MIKE MCBRIDE CHECK AMOUNT: $764.13
s, 1, CP,RMEL, INDIANA 46032 C/O ENGINEERING
CIO ENGINEERING
CHECK NUMBER: 168806
CHECK DATE: 2/11/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 764.13 ROUNDABOUT CONFERENCE
i
COURTY Washington by Marriott 1900 Connecticut Ave Nw
Washington Northwest Washington Dc 20009
Aarnott T 202.332.9300
M Mcbride Room 704 z
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Number of Guests �1 r
s� �r t� :vim' j s a
t
s"� z 'S d 'tai: ;1
Arr ve 12Jan09 Time 102a34RM 3pepart �5Jan09 Time Fn to Number �887�
4�3, ts.,�s7 sue- ���,....1,.. �s £..,.......a r� W�Y. z. �2<,..,, �i .�.;..��"'��,a� ,��..M;
12Jan09 Daily Parking 25.00.
12Jan09 Parking Tax 3.00
12Jan09 Room Charge 198.00
12Jan09 Room Tax 28.71
13Jan09 Room Charge 198.00
13Jan09 Room Tax 28.71
14Jan09 Room Charge 198.00
14Jan09 Room Tax 28.71
14Jan09 AR Payments 0.00
14Jan09 Misc. Sales 0.00
15Jan09 708.13
Card XXXX
Amount: 708.13 Auth: 36992Z Signature on File
This card was electronically swiped on 12Jan09
Balance: 0.00
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4` n TNE
CITY OF CARMEL Expense Report (required for all travel expenses)
`�NDIANA�
EMPLOYEE NAME: Mike Mcbride DEPARTURE DATE: 1/12/2009 TIME: AM/PM
DEPARTMENT: Engineering RETURN DATE: 15 -Jan TIME: AM/PM
REASON FOR TRAVEL: Roundabout Conference DESTINATION CITY: Washington, D.C.
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT X PER DIEM
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
1/12/09 $15.00 $15.00
$0.00
1/15/09 $18.00 $18.00
1/15/09 $15.00 1 $15.00
1/15/09 $8.00 $8.00
1/12/09 $708.13 $708.13
$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 $48.00 $8.001 $708.13 $0.00 $0.00r $0.00 so-001 $0.001 $0.00 $764.13
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. 1 2!� Director Signature: Date: 21 0
City of Carmel Form ER06 Revision Date 2/2/2009 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: Date:
City of Carmel Form ER06 Revision Date 2/2/2009 Page 2
Prescribed by Stale 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
Mike McBride
Purchase Order No.
Engineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/15109 n/a Taxi Cab Fare (D.C. Roundabout Confrence) 18.00
01/15/09 n/a Airport Parking Inpls. Intntl. (D.C. Roundabout Conf.) 8.00
01/12/09 n/a NWA Baggage Charge (D.C. Roundabout Conf.) 15.00
01/15/09 n/a NWA Baggage Charge (D.C. Roundabout Conf.) 15.00
1115109 n/a Courtyard Marriott (D.C. Roundabout Conf.) $708.13
TOW 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
Make MrFtrad IN SUM OF
Engineering Department
$764.13
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a nra 2200 4343002 $764.13 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
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund