209384 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 318025 Page 1 of 1
ONE CIVIC SQUARE DAVID R VANDERBECK CHECK AMOUNT: $1,608.55
CARMEL, INDIANA 46032
CHECK NUMBER: 209384
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343003 1,587.55 TRAVEL LODGING
1110 4351100 21.00 CAR CLEANING
CITY OF CARMEL Expense Report (required for all travel expenses)
EMPLOYEE NAME: DAVID VANDERBECK DEPARTURE DATE: 5/11/2012 TIME: 400 AM PM
DEPARTMENT: CARMEL PD RETURN DATE: 5/16/2012 TIME: 1900 AM/PM
REASON FOR TRAVEL: HONOR GUARD DESTINATION CITY: WASHINGTON D.C.
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Transportation Gas /Tolls/ Meals
Date Parkin Lodging Misc. Total
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
5/11/12 $65.00 $65.00
5/12/12 $13.00 $65.00
5/13/12 $4.00 $65.00 $69
5/14/12 1 $65.00 $65.00
5/15/12 $65.00 $65.00
5/16/12 $8.00 $1,193.55 $65.00 $1,266.55
$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 $21.001 $4.00 $1,193.55 $0.001 $0.00 $0.00 $0.00 $390.00
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated bu
Director Signature: Date:
City of Carmel Form ER06 Revision Date 5/18/2012 Page 1
HOMEWOOD 4850 Leesburg Pike Alexandria, VA 22302
S�T Phone (703) 671 -6500 Fax (703) 671 -9322
Reservations
Name Address Hilton homewoodsuites.com or 1- 800 -CALL -HOME
VANDERBECK, DAVID Room 309/TGSN
Adult/Child 2/0
Room Rate 219.00
RATE PLAN LV3
HH# 905655612 BLUE
AL:
BONUS AL: CAR:
CONFIRMATION NUMBER: 82491375
5/16/2012 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT
5/11/2012 1648305 GUEST ROOM $219.00
5/11/2012 1648305 STATE TAX $10.95
5/11/2012 1648305 COUNTY TAX $8.76
5/12/2012 1648470 GUEST ROOM $219.00
5/12/2012 1648470 STATE TAX $10.95
5/12/2012 1648470 COUNTY TAX $8.76
5/13/2012 1648664 GUEST ROOM $219.00
5/13/2012 1648664 STATE TAX $10.95
5/13/2012 1648664 COUNTY TAX $8.76
5/14/2012 1648872 GUEST ROOM $219.00
5/14/2012 1648872 STATE TAX $10.95
5/14/2012 1648872 COUNTY TAX $8.76
5/15/2012 1649056 GUEST ROOM $219.00
5/15/2012 1649056 STATE TAX $10.95
5/15/2012 1649056 COUNTY TAX
WILL BE SETTLED TO $1,193.55
EFFECTIVE BALANCE OF $0.00
EXPENSE REPORT SUMMARY
1 00:00:002 12:00:OOAM 012 12:00:OOAM12 12:00:OOAM
ROOM TAX $238.71 $238.71 $238.71 $238.71
DAILY TC TAL $238.71 $238.71 $238.71 $238.71
EXPRESS CHECK -OUT DATE OF CHARGE FOLIO NO. /CHECK NO.
Good Morning We hope you enjoyed your stay. With Express Check -Out AUTHORIZATION 187171 JL
there is no need to stop at the Front Desk to check out.
Please review this statement. It is a record of your charges as of late last
evening. PURCHASES SERVICES
For any charges after your account was prepared, you may:
pay at the time of purchase. TAXES
charge purchases to your account, then stop by the Front Desk for an
updated statement.
or request an updated statement be mailed to you within two business days. TIPS MISC.
Simply call the Front Desk from your room and tell us when you are ready to
depart. Your account will be automatically checked out and you may use this
TOTAL AMOUNT
statement as your receipt. Feel free to leave your key(s) in the room. 0.00
Please call the Front Desk if you wish to extend your stay or if you have any
questions about your account.
PAYMENT DUE UPON RECEIPT 1.5% PER MONTH INTEREST CHARGE WILL BE APPLIED TO ALL PAST DUE INVOICES.
IMF
HOMEWOOD 4850 Leesburg Pike Alexandria, VA 22302
ST n T Phone (703) 671 -6500 Fax (703) 671 -9322
VL 1 s Reservations
Name Bs Address Hilton homcwoodsuites.com or 1- 800 -CALL -HOME
VANDERBECK, DAVID Room 309/TGSN
703 BENNETT RD Arrival Date 5/11/2012 1:17:00PM
Departure Date 5/16/2012
CARMEL, IN 46032
US Adult/Child 2/0
Room Rate 219.00
RATE PLAN LV3
HH# 905655612 BLUE
AL:
BONUS AL: CAR:
CONFIRMATION NUMBER: 82491375
5/16/2012 PAGE 2
DATE REFERENCE DESCRIPTION AMOUNT
1 00:00:00 STAY TOTAL
ROOM TAX $238.71 $1,193.55
DAILY TC TAIL $238.71 $1,193.55
You have ear ied approximately 10950 Hilton HHonors points for this stay. Visil HHonors.com to check
your point ba nce from stays at any of the 3,700 hotels within the Hilton Worldvide portfolio.
EXPRESS CHECK -OUT DATE OF CHARGE FOLIO NO. /CHECK NO. 7V Good Morning We hope you enjoyed your stay. With Express Check -Out AUTHORIZATION 187171 ITIAL
there is no need to stop at the Front Desk to check out.
Please review this statement. It is a record of your charges as of late last
evening. PURCHASES SERVICES
For any charges after your account was prepared, you may:
pay at the time of purchase. TAXES
charge purchases to your account, then stop by the Front Desk for an
updated statement.
or request an updated statement be mailed to you within two business days. TIPS MISC.
Simply call the Front Desk from your room and tell us when you are ready to
depart. Your account will be automatically checked out and you may use this
TOTAL AMOUNT
statement as your receipt. Feel free to leave your key(s) in the room. 0.00
Please call the Front Desk if you wish to extend your stay or if you have any
questions about your account.
PAYMENT DUE UPON RECEIPT 1.5% PER MONTH INTEREST CHARGE WILL BE APPLIED TO ALL PAST DUE INVOICES.
VOUCHER NO. WARRANT NO.
ALLOWED 20
David R. Vanderbeck
IN SUM OF
$1,608.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 43- 511.00 $21.0 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1110 43- 430.03 $1,587.55
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, May 18, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor 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 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))
05/17/12 car washes Police Memorial week $21.00
05/17/12 reimbursement for Police Memorial week $1,587.55
1 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