HomeMy WebLinkAbout213563 10/09/2012 ��. CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1
ONE CIVIC SQUARE MIKE MCBRIDE
CARMEL, INDIANA 46032 C/O ENGINEERING CHECK AMOUNT: $452.84
CIO ENGINEERING
CHECK NUMBER: 213563
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 452 . 84 EXTERNAL TRAINING TRA
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CITY OF CARMEL Expense Report (required for all travel expenses)
/NO,AroPu EXHIBIT A
EMPLOYEE NAME: Mike McBride DEPARTURE DATE: 10,1-2 TIME: emy PM
DEPARTMENT: Engineering RETURN DATE: TIME: AM M
REASON FOR TRAVEL: _TACT Meeting DESTINATION CITY: LaS�/`I
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air-fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
10/2-10/4 $286.38 $286.38
10/3/12 $50.00 $50.00
10/4/12 $50.00 $50.00
10/2/12 $16.50 $16.50
$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 $0.001 $0.001 $0.00 $0.001 $402.881 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
DIRECTOR'S STATEMENT hereby affirm that all expenses list d conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 10/8/2012 Page 1
AWL
FMNCH LICK
RESORT
Name: MIKE MCBRIDE Arrival Date: 10/02/2012 Cl Clerk FHU
Address: 300 S MERIDIAN ST Departure Date: 10/04/2012 CO Clerk RPADGETT
INDIANAPOLIS IN 46225 Group Code: 101 21A
Room,#: FL 1518 Resv 409814945361 Page 1 of 1
Date Reference Description Charges re its
10102120-12- 411839000099 ROOM-CHARGE-FL 1518 -129.00
TAX II 9.03
TAX2 5.16
10/03/2012 411849000099 ROOM CHARGE FL 1518 129.00
TAX1 9.03
TAX2 5.16
10/04/2012 411851229686 FL FRONT DESK 286.38
Total Due .00
I agree to remain personally liable for the payment of this account if the corporation or other third party
fails to pay part or all of these charges. I also agree that all charges contained in this account are correct
and any disputes or requests for copies of charges must be made within five (5) days after my departure.
If you are using a credit card, the hold may last up to 3 business days past your check-out date. If you
are using a debit card, the hold on funds may last from 7-10 business days after your check-out date.
Guest Signature:
French Lick Springs Hotel 8670 West St Road 56 French Lick, IN 47432
888.936.9360 frenchlick.com
TRAVEL / EXPENSE
REIMBURSEMENTS
For: Oct. 8, 2012
Mileage to Milea a Back Parking Other Total Miles Total
Date Meeting Description Start Finish Start Finish Cost Costs Other Description Miles x$.555 Expense
9/13/2012 Meeting with Kent Ward&Mike Howard 61102 61125 $0.00 $0.00 23 $12.77 $12.77
(County Government Ctr)
9/20/2012 Hamilton County MPO Mtg(Hamilton Co 61352 61376 $0.00 $0.00 24 $13.32 $13.32
Highway Dept)
9/25/2012 16th&Hazel Dell Project Meeting(DLZ 61585 61628 $0.00 $0.00 43 $23.87 $23.87
Office Downtown)
10/4/2012 TACT Conference in French Lick Hotel $0.00 $286.38 Hotel 2 Nights $0.00 $286.38
10/4/2012 TACT Conference in French Lick Two Days 00 $16 50 2 SAYS -S
Per Diem&Fuel For City Vehicle $0. . Ihs $0.00 $16.50
$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
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
i $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
Refund Total $352.84
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Governmental Unit
On Account of Appropriation No. ZO } for Ty-«v2 ,'
( ice,Board, Depart nt or Institution
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE
20� Point Point Start Finish TRAVELED PER MILE
, l crL 2 ✓ I Z 2 �-
20 i l 2 �o Z
Z cam\ Z �'`^ `, 1 g
Auto License No. TOTALS p All 9
* 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 10).5 12 °'
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
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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
'v'-1\f'`' c6 Q Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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.
1� 'n ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
2200
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
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
�o (2 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund