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Home My WebLink About208837 05/10/2012 \�f CITY OF CARMEL, INDIANA VENDOR: 354306 Page 1 of 1 ONE CIVIC SQUARE MICHAEL PITMAN CARMEL, INDIANA 46032 CHECK NUMBER: 208837 CHECK DATE: 5/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4231400 133.01 GASOLINE 1110 4343002 460.00 EXTERNAL TRAINING TRA ,piK e N CITY OF CARMEL Expense Report (required for all travel expenses) �NDIANP S EMPLOYEE NAME: Michael Pitman DEPARTURE DATE: 4/27/2012 TIME: 8:00 RPM M DEPARTMENT: Carmel Police Department RETURN DATE: 5/3/2012 TIME: :00 REASON FOR TRAVEL: Training DESTINATION CITY: St. Paul, Minnesota EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM (Yv Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 4/27/12 $35.00 $65.00 $100.00 4/27/12 $70.00 $70.00 a 4/28/12 $65.00 $65.00 4/29/12 $65.00 $65.00 4/30/12 $65.00 $65.00 5/1/12 $65.00 $65.00 5/2/12 $65.00 $65.00 5/2/12 $51.41 $51.41 5/2/12 $46.60 $46.60 $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 $0.001 $0.001 $203.011 $0.001 $0.00 $0.001 $0.00 $0.001 $390.00 $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 5/7/2012 Paso Crowne P Hot el Self Parking RS i`�l amp: CJ n ce Zoom. t( IPMBA C Da t e: i�lo10 Aay 5, 2012 Registration Form Page 1 of 2 I /a I h1 1' cur 2 uc -1 c of tease check all boxes that apply and add Re_ -sue'0 I I s up the right column for your total. You Ra te pe r night 1 24, 2012 can register for just the pre- conference, just J the conference, or, ideally, both! i��llei� b' posed You must be a current member to attend any of the pre conference training courses Join or renew below if you are not currently a member. Home Address pp Bicycle Response Team Training $375 EMS Cyclist Course L3 $325 Sbe •l Add,••• IPMBA Instructor Course $550 c°y sur. o +eiCOd• county 1P 14BAlnstruCtor Application enclosed L3 $125 Home You must apply and be approved to attend Contact the IPUBA office with questions Personal Telephone Maintenance Officer Certification Course $525 E -Mail A� 0 r' P (A rn F- l IN b f MMR -IPMBA Core Skills Scenarios Clinic. $495 tco*m fmn. ,ib t coif „eta n•l 325 Dept. Name Police Cyclist Course Dept. Address L d i IPMBA Member Fee $406 sa••t Add,•.: LAO O y, j 5 MUST be current, you must provide this cunenf IPMBA membership y VlJ 7 4 number on this form ar pmtenow with this regrsvatron cdy svr. P °•+'c°d• c°unlry Non -IPMBA Member Fee $475 Dept. Telepho `s es Fee for Pre- Conference Attendees O $350 �r ,eti It you are ahendrng any of the Pre- Conference training IPMBA Membership Number f' courses this is the fee you pay to also attend the conference (Morrdofoy /�unenl�nd rene� gmembersJ Bike Team Rate E) $350 IPMBA Instructor Numb 11 /A II See box in left column for details Tee Shirt Size ❑M ❑L 117 L DXXL ❑XXXL ty-u wdl LARGEd y°u don t chacA Guest Fee (per guest) Guests x $50 y The guest too entitles your guest admission to the exhibit hall end two lunches NAME(s) L unches are included In the cost of each pre conference course During the Rush Fee 25 conference, lunches will be served on Thursday and Friday, please check the Ragrstratlons submntedarter March2t, 2012, must ;.clue• the rush tee appropnate boxes on the reverse All other meals are on your own Exhibit Hall -Only Pass (Pre Registration Requxed) Free MMI EM Register three or more members from the same agency at a flat rate of New Renew 50 $350 per team member The following conditions apply Applies to CONFERENCE fees only Does NOT apply to Pre Conference Course Fees TOTAL ENCLOSE,) J`r7 5-Oro. Can be used by both conference -only attendees and those attending both a CANCELLATfoNPOL1CY Refund requests must be made rnwntrng and postmarked by pre conference course and the conference March 24, 2012 Refunds, less a $50 aontrnstration fee, will be Processed following the Registrants MUST be IPMBA members (current, joining, or renewing) conference bs7rtufeandsub hs/herregistration a 7orn umust canw a fter esarg rcil24,youotgelsocafea and a letter Registrations MUST be submitted together (offer not available online) MembersMp, cenl6cahon, and mstruclorOPOWtron fees are non-refundable IF YOU ARE REGISTERING FOR THE CONFERENCE, HAVE YOU COMPLETED PAGE 2 OF THIS FORM? e I I Form of Payment [MUST ACCOMPANY REGISTRATION] Purchase Order number Check or money order (payable to IPMBA) enclosed or departmental equlvalent C] Visa /MasterCard accepted (circle one) Exp ire I I— _1., -1�j —_jam I D•W lmrnl l°whith lbe NW CB Shdub .OM --_L— Signature Name on card A Email address for receipt Contact Add eu phone Cey 1 %n ce rdF e, d /rc W /2rriiopnno/ ,Wla 1 rt>riirr�aiirOi.Fe,lrrr r r Ilk/ 1� 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)) 05/07/12 reimbursement for gasoline $133.01 05/07/12 reimbursement for meals parking $460.00 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 Michael A. Pitman IN SUM OF $593.01 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1110 42- 314.00 $133.01 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1110 43- 430.02 $460.00 materials or services itemized thereon for which charge is made were ordered and received except Monday, Ma 07, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund =z Z g \ƒ .d SSG' rvllday 3453k. 18#5 /BROADWAY M;Ao 2\ {a. CIEDI CARD SALE> SS#- HOLIDAY #3459/6 @4/27/£2 TIME: IW Stare# 459 I■rminal :@@@1 »2 NCi XXXX554l #.Ot CREDIT /SbER Un %■ads A 1@ $3.7 9Zp! v0L UNE 9.212 AL a GA$ f07jAL $55 IOT�AL $35 e w I AGREE, TO PAY THE2 2 ABOVE TOTAL ANOUNTd' p AcpOR IMG TO THE r« CAR AGREEMENT. INVkT 155881283 !y AP\ROVA 519838 I/2 PITMAN /MICHAEL A2 ƒ .«k`ANK YOU FOR YOUR BUSINESS i,,E ]COME TO GROMANNS 688121 GRO MANNS PLAZA 1362 RAYMOND MEHDOTA IL DA" E OE /02i 12 20:37 PUP1P 02 PRODUCT: BLUE GALLONS: 12.288 PR::CE /C g :3.786 FUEL SALE S 46.60 Flui'.h 6c7S26 Rei' 2667SO07 Re =.sp Code: 000 Stan: 06046SSO04 SI' E !D: SSS8121 Earn rebates with BP Visa Ta F, e application and App 1 Today THANK YOU GOD BLESS AMERICA 5 County Road A Black River Falls Wi 54615 I -94 BP 5 County Road A Black River Fall, Wi 54615 65/82/2812 84:42:29 PM 157983628 PUMP# 5 BLUE 13.899 PRICE /GAL 3.699 FUEL TOTAL 51.41 Subtotal 51,41 Tax 0.00 TOTAL 8 51.41 CREDIT 51.41 XXXXXXXXXXXX5541 Auth 679538 Ref: 38672881 Resp Code: 888 Stan: 384745291293 SITE ID: 6591937 Earn rebates with BP Visa Take application and Apply Today Thank You!! Please Stop Again!!