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209400 05/22/2012 *f CITY OF CARMEL, INDIANA VENDOR: 00350947 Page 1 of 1 0 k ONE CIVIC SQUARE W EDWARD WOLFE CHECK AMOUNT: $25.00 CARMEL, INDIANA 46032 22934 ANTHONY ROAD CICERO IN 46034 CHECK NUMBER: 209400 CHECK DATE: 5/22/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 25.00 OTHER EXPENSES CITY OF CARMEL Expense Report (required for all travel expenses) 2010 mileage reimbursement rate is 50 cents /mile EMPLOYEE NAME: Ed Wolfe DEPARTED na TIME: DEPARTMENT: Utilities /Sewer RETURN na TIME: REASON FOR TRAVEL: na DESTINATION CITY: na EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM Date Transportation Gas/Tolls/ Lodging Meals Misc. Total Air -fare Car Rental Other Parking Breakfast Lunch I Dinner I Snacks Per Diem 5/3/12 Continuing Education $25.00 $25.00 $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 Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $25.00 r=9 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 5/4/2012 Page 1 Certificate of Completion Approved Environment, Inc. Page 1 of 1 Approved Environment, Inc. P.O. Box 42744 Indianapolis, IN 46242 1 -87'1-241 -9858 Email: SupporWapprovedce.com Certificate of Completion Courses are approved in the folloivin.g states: Indiana. Illinois, Ohio. Alabama, Delaxyare. South Carolina. North Carolina. Marylarnd, Kentucky and Ontario. Canada. Name: WILLIAM WOLFE Address: 9609 HAZEL DELL PKWY, INDIANAPOLIS, IN 46280 Course Title: Solids Handling Alternatives Course Value: 1 Contact Hour Approval Number: IN WWT11 -5912 TO1 -GOO, OH OEPA- S296742 -OM, NC CE02030403, MD 3471- 05 -06, KY 10301 Date: 5/3/2012 Approximate Time Spent Taking the Course: 60 minutes. Operator Certification License Number: WWO06430 Operator Class Level: IV License Expiration Date: 06/30/2012 Operator Signature: Training Provider Signature: 4 4, Ann Bersbach, Approved Environment, Inc. Copyright 2002, Approved Environment inc.. Indianapolis. Indiana http:// www. approvedee. com/ onlineCEUs /ceuCertificateOfCompletion.asp 5/3/2012 Transaction Details Page 1 of 1 Transaction Details 6 FORUM* -�p 0 R E© I T U N 1 O N 5/4/2012 Eff. 51312012 WITHDRAWAL APPROVED ENVIROMENT IN APPROVE D ENVIROMEN INDIANAPOLIS INUS Trace #395682 0 $25.00 Hide Memor`Categorizations MEMO (No memo text) CATEGORIES Uncategorized 525.00 Generated on 5/4/2012 1:48:27 PM e; 2011 FORUM Credit Union. All nahts reserved. https:// www. forumcuonline .com/History/PrintTransaction 5/4/2012 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 $32.50 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 $32.50 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: City of Carmel Form ER06 Revision Date 5/4/2012 Page 2 VOUCHER 117282 WARRANT ALLOWED T1032 IN SUM OF Wolfe, Edward WWTP Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 050312 01- 7042 -05 $25.00 Voucher Total $25.00 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T1032 Wolfe, Edward Purchase Order No. WWTP Terms Due Date 5/4/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/4/2012 050312 $25.00 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 jille, Date P Offic