214320 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1
t ONE CIVIC SQUARE DOUGLAS HANEY
CHECK AMOUNT $512.30
CARMEL, INDIANA 46032 C/0 DEPT OF LAW
C/O DEPT OF LAW CHECK NUMBER: 214320
CHECK DATE. 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343002 512 30 CHIAGO
/ c�1 PT.YpAq�F(
CITY OF CARMEL Expense Report (required for all travel expenses)
�/NDIANp�
EMPLOYEE NAME Douglas C Haney DEPARTURE DATE 10/02/12 3.00 p m
DEPARTMENT Law Department RETURN DATE 10/04/12 TIME 1000 p m
REASON FOR TRAVEL PLI Federal Civil Practice 2012 DESTINATION CITY Chicago, Illinois
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
Oct. 2 -4,
2012 $51 00 $36380 $9750 $512.30
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
0 00
Total $000 $000 P-00 $51 00 $363.80 $000 $000 $0.00 $000 $97.50 $0 00
DIRECTOR'S STAT I hereby affirm that all expenses listed conform to the City's travel policy and are iwithin my department's appropriated budget.
Director Signature Date
City of Carmel Form#ER;6 Revision Date 10/17/2012 Page 1
® • s
0
Llm eo
PRACTISING LAW INSTITUTE 810 Seventh Ave New York, NY 10019-5856 t 212 824 5700 f 800 321 0093 www pli.edu
Certification of Course Completion
The Practising Law Institute certifies that the registrant indicated below participated
in the course described and is eligible to receive the CLE credit hours as stated
Registrant: Douglas Haney
City of Carmel Dept of Law
1 Civic Sq
Carmel IN 46032-2584
Bar Number- 11207-49
Program Title- Federal Civil Practice Update 2012 A Practical Guide to New
Developments,Procedures& Strategies
Roberta S.Karmel,
Chair of the Board
William P Frank,
Chair of the
Executive Committee Program Type Live Seminar
Victor J Rubino, Program Segment: N/A
President g g
Board of Trustees Activity Code/
Course Number-
David David M.Balabanian
Charles E.Barnett
Devereux Chatillon For the State of IN
Douglas S.Eakeley
Stephen J Friedman Date Completed. 10/3/2012
Edward F Greene
Hon.William F Kuntz II
Carmen J Lawrence Total CLE Credits Hours
Lance Liebman 5.30
James L.Lipscomb General
Hon.Marc Marmaro 4.30
Hon.Angela M.Mazzarelli Ethics 1 00
Frederick P Schaffer
Samuel W Seymour
John S.Siffert
Hon,Sidney H.Stein
Hon.Elizabeth S.Stong
Gregory C.Swinehart
Dean Joan G.Wexler
John W White
Kathryn D.Wriston /
Chairmen Emeriti
Barry H.Garfinkel
Jerome E.Hyman Andrew D Ottiger
E.Nobles Lowe Director, MCLE Accreditation &Compliance
Werner L.Polak
Robert B.von Mehren 10/5/2012
Trustees Emeriti
Edward C.Cazier Jr
Hon.John J Gibbons
William F Kennedy
Robert MacCrate
Phil C.Neal
Hon.Lawrence W Pierce
John J.Roche
Leon Silverman
873092 35469
511 North Columbus Drive Chicago,IL 60611
Phone(3 12)836-5900 Fax(3 12)836-5901
E M n A S S Y S U I T E S For reservations across the nation
Name&Address IF,O T E L S• WWW.embassysuites.com or 1-800-EN,113ASSY
HANEY DOUGLAS Suite 1223/KNGN
13828 SMOKEY RIDGE DR Arrival Date 10/2/2012 9:29-OOPM
Departure Date 10/3/2012
CARMEL, IN 460339101
US Adult/Child 1/0
Suite Rate $312.55
RATE PLAN S-AAA
HH# 864254159 DIAMOND
AL DL #6061240013
BONUS AL CAR
Confirmation. 84989400
101312012 PAGE 1
DATE REFERENCE DESCRIPTION AMOUNT
10/2/2012 4848640 VALET PARKING $51 00
10/2/2012 4848807 GUEST ROOM $312.55
10/2/2012 4848807 STATE TAX $37 19
H-
10/2/2012 4848807 CITY TAX $1406
WILL BE SETTLED TO $41480
EFFECTIVE BALANCE OF $000
ESTIMATED CURRENCY TOTAL
Hilton HHonors('?)stays are po ted within 72 hours of checkout. To check your earnings for this r any other stay at more han 3,000 Hilton
Family hotels worldwide,pleas visit HiltonHHonors.com.
Thank you for saying with us. Visit embassysuites.com for more information on hotel packages, ubscribe to our E-nnoun ements newsletter
or plan your ne stay at closet 200 destinations.
EXPRESS CHECK-O UT DATE OF CHARGE F01_IO NO./CIIBCK NO N7 848924 A
Good N,Iorning ! We hope you enjoyed your stay With Express Check-Out AUTHORIZATION INITIAL 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 0
updated statement.
•or request an updated statement be mailed to you Within two business days. TIPS&MISC.
Simply call the operator from your suite and tell us when you are ready to
depart. Your account will be automatically checked out and you may use this
TO'GAL AMOUNT
statement as your receipt. Feel free to leave your key(s)In the suite. 0 00
Please call the operator if you mush to extend your stay or if you have any
questions about your account.
INDIANA RETAIL TAX EXEMPT PAGE
City ®f C ar}�'� el CERTIFICATE NO.003120155 002 0 J�l \\��11//// J�111�1 JJLL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT f y�
35-60000972 �J
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO VENDOR NO DESCRIPTION
t
•( SHIP
VENDOR `' ' TO
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
,.+`'4!t'(..`'. .CfVLL-"=. °j,,""'' :.Rt,.✓ ...e pP: Ui;Lr/f /' ,(,,/i r..+
>
�,'•fit,:,�Q,�x.�., G,� �:?�<C, t :�� -`- <��� :,. ,,.-iS( °r`��A".e<,t
.}•f�> / `�i\�.✓�i �F,��.Lf R�i°�ti�ti'"r CR ;!-^/�:iti� f,+8i^��' ��;s ,�"`_4� !
m°
Send Invoice To
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT ,�1-5✓ 0
r / A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
✓ �v'�`� %`y�'r E '/ j °�y , (+.a•5 -. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
f VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO J_ v -.
;) g CLERK-TREASURER
DOCUMENT CONTROL NO A•P V COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO WARRANT NO __ __
ALLOWED 20___
|N THE SUM OF$
ON CCOUNTe4ROPR|AT|ONFOR
Pb#or r
Board Members
INVOICE NO ACCT#/TITLE AMOUNT | hereby certify that the attached immice(s). or
bill(s) is (are) true and onrroctiand that the
materials or services itemized*thereon for
which charge ia made were ordered and
vece|vedexou[d______ __
Title
Cost distribution ledger classification h
claim paid motor vehicle highway fund