216029 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00352832 Page 1 of 1
ONE CIVIC SQUARE FIFTH THIRD BANK
CARMEL, INDIANA 46032 ACCT#XXXX-XXXX-XXXX-2798 CHECK AMOUNT: $6,046.00
PO BOX 740523 CHECK NUMBER: 216029
CINCINNATI OH 45274-0523
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343007 2798 763 .20 FIELD TRIPS
1081 4357004 2798 4, 875 . 00 EXTERNAL INSTRUCT FEE
1125 R4355300 29274 2798 244 . 00 P-CARD CHARGES
1125 R4343000 29277 2798 163 . 80 HOTEL FEES
Fifth Third Bank
ACCOUNT NUMBERXXXX XXXX XXXX 2798
FIFTH THIRD BANK
PO BOX 740523 PAYMENT DUE DATE 01-25-13
CINCINNATI OH 45274-0523 AMOUNT DUE $6,046.00
CURRENT BALANCE $6,046.00
FIFTH THIRD BANK
PO BOX 740523
CINCINNATI OH 45274-0523 AMOUNT
ENCLOSED $
CARMEL CLAY PARKS & RECR ~TOOOa72a
CORPORATE BILLING ACCT
C!0 AUDREY KOSTRZEWA
1411 E 116TH ST
CARMEL IN 46032-3455
5569260004422798 0006046007 0 006046007
Please tear payment coupon at perforation.
STATEMENT-MESSAGES
For your protection,the card activation line has been enhanced to require zip code in addition to your card number and
unique ID.
If you receive a new card,and do not know your zip code, please contact your program adminis Irator.
JAN 0 2 2013
i
CORPORATE ACCOUNT SUMMARY.
CORPORATE ACCOUNT NUMBER
XXXXXXXXXXXX2798
CLOSING DATE 12-31-12 PREVIOUS BALANCE 1,512.80
PAYMENT DUE DATE 01-25-13 PURCHASES AND OTHER CHARGES 6,046.00
CREDIT LIMIT 40,000 CASH ADVANCES .00
AVAILABLE CREDIT 33,954 CREDITS .00
PAYMENTS 1,512.80-
FOR CUSTOMER SERVICE CALL: LATE PAYMENT CHARGES .00
1-800-375-1747
CASH ADVANCE FEE .00
SEND BILLING INQUIRIES TO: FINANCE CHARGES .00
FIFTH THIRD BANK NEW BALANCE 6,046.00
P.O. BOX 630781
CINCINNATI OH 45263-0781 TOTAL PAYMENT DUE 6,046.00
DISPUTED AMOUNT .00
Page 1 of 2
ACCT. NUMBER: XXXX XXXX XXXX 2798
CREDIT LIMIT 40,000.00 CASH ADVANCE BALANCE .00
CURRENT BALANCE 6,046.00 MINIMUM PAYMENT DUE 6,046.00
AVAILABLE CREDIT 33,954.00 PAYMENT DUE DATE 01-25-13
CORPORATE ACCOUNT ACTIVITY.,..
CARMEL CLAY PARKS&RECREATION TOTAL CORPORATE ACTIVITY
XXXX-XXXX-XXXX-2798 $1,512.80 OR
Post Trans
Date Date Reference Number Transaction Description Amount
12-11 12-10 75569262345000000000179 PAYMENT RECEIVED-THANK YOU 1,512.80 PY
INDIVIDUAL CARDHOLDER ACTIVITY .
DAWN R KOEPPER CREDITS PURCHASES CASH ADV TOTAL ACTIVITY
XXXX-XXXX-XXXX-2814 $0.00 $5,638.20 $0.00 $5,638.20
Post Trans
Date Date Reference Number Transaction Description VON Amount
12-03 12-01 55457022336206620700041 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700058 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700066 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700074 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700082 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00,
12-03 12-01 55457022336206620700090 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700108 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700124 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700157 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700173 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700181 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-03 12-01 55457022336206620700199 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-04 12-04 55457022339206620000019 NATL AFTERSCHOOL ASSN 07036109000 VA 375.00
12-12 12-11 55432862346000283779864 INDIANA PACERS 317-917-28271N 763.20
MICHAEL W KLITZING CREDITS PURCHASES CASH ADV TOTAL ACTIVITY
XXXX-XXXX-XXXX-2421 $0.00 $407.80 $0.00 $407.80
Post Trans
Date Date Reference Number Transaction Description VON Amount
12-17 12-15 85180132350050300001638 HILTON HOTEL AMERICAS HOUSTON TX 163.80
0002673313 ARRIVAL:i2-14-12
12-17 12-14 85500392351400007560034 ILIPRA 00 OF 00 708-5882284 IL 244-00
Page 2 of 2
12/3/2012
It ,,..
Receipt Customer ID: 6109475
_ Invoice Number: 003650
��. ",
�.. _ I Invoice Date: 11/30/2012
DEC 0 3 2012
I
BY: _.,�__ __� Please remit payment to:
Ben Johnson National Afterschool Association
Manager 8400 Westpark Drive, 2nd Fl
Carmel Clay Parks & Recreation Mclean, VA 22102
1235 Central Park Drive East United States
Carmel, IN 46032 (P) (703) 610-9000
(F) (703) 610-9003
Order Tracking #003830 - 6109475
Balance Due: $0.00
Total Payment Amount $
Ben Johnson Customer ID: 6109475
Manager
Carmel Clay Parks & Recreation Invoice Number: 003650
1235 Central Park Drive East Invoice Date: 11/30/2012
Carmel, IN 46032
' errx a _ •\• __ . nttp i._ utlp A8'm
Annual Convention - Two Days:
Monday/Tuesday Only& Membership $375.00 i 1 $375.00
_. ,.�.._.M ..__ .. _... . _,..._..•.._..... ._...._.._._..•........._.............. ..._•_._.............._... _. i._._.............__.M_..... _._... _......... ... .. ...u_.
-Full Membership
Term: 11/30/2012 - 11/29/2013
-2013 NAA Annual Convention(Badge
Name: Johnson Ben)
Subtotal ,_.•,. ^` µm`J$375.00H
Invoice Total $375.00
Balance Due , $0.00
Last Payment On This Invoice: Paid by MasterCard ending in 2814 on 11/30/2012
12/3/2012
Receipt Customer ID: 003790
Invoice Number: 003560
r_i:;:- -, Invoice Date: 11/30/2012
DEC 0 3 2012
Please remit payment to:
Trina Floyd-Messer ��._
Y National Afterschool Association
Site Supervisor 8400 Westpark Drive, 2nd Fl
Carmel Clay Parkes & Recreation Mclean, VA 22102
1411 E. 116th Street United States
Carmel, IN 46032 (P) (703) 610-9000
(F) (703) 610-9003
Order Tracking #003730 - 003790
Balance Due $0.00
Total Payment
Trina Floyd-Messer Customer ID: 003790
Site Supervisor
Carmel Clay Parkes & Recreation Invoice Number: 003560
1411 E. 116th Street Invoice Date: 11/30/2012
Carmel, IN 46032
k;n'it,Pri ..»..i
Annual Convention - Two Days:
Monday/Tuesday Only& Membership i $375.00 1 $375.00
-2013 NAA Annual Convention(Badge
Name: Floyd-Messer Trina)
-Full Membership
Term: 11/30/2012 - 11/29/2013
Subtotal ' $375.00
Invoice Total $375.00
Balance Due i $0.00
Last Payment On This Invoice: Paid by MasterCard ending in 2814 on 11/30/2012
12/3/2012
Receipt Customer ID: 6108990
Invoice Number: 003550
Invoice Date: 11/30/2012
7DEC 0 3 2012 Please remit payment to:
Valeska Simmonds _---- - — =j National Afterschool Association
Carmel Clay Parks and Recreation 8400 Westpark Drive, 2nd Fl
1235 Central Park Drive East Mclean, VA 22102
Carmel, IN 46032 United States
(P) (703) 610-9000
(F) (703) 610-9003
Order Tracking #003720 - 6108990
Balance Due` $0.00
Total Payment Amount$
Valeska Simmonds Customer ID: 6108990
Carmel Clay Parks and Recreation Invoice Number: 003550
1235 Central Park Drive East
Carmel, IN 46032 Invoice Date: 11/30/2012
T
.te rc i 9isc. r �$t"t:!:fates .,.. alien. Pric� �....Amnuot
Annual Convention -Two Days:
Monday/Tuesday Only& Membership $375.00 1 $375.00
i -....... __._..... �. .__ _,.,_. ...
-Full Membership i
Term: 12/6/2012 - 12/5/2013
-2013 NAA Annual Convention(Badge
Name: Simmonds Valeska
Subtotal ' $375.00
Invoice Total i $375.00
Amount Paid $375.00
Balance Due $0.00
Last Payment On This Invoice: Paid by MasterCard ending in 2814 on 11/30/2012
12/3/2012
b iCMB 'f
Receipt Customer ID: 8638809
Invoice Number: 003540
Invoice Date: 11/30/2012
DEC
03 2012
Please remit payment to:
James A Dowell —" National Afterschool Association
Site Supervisor 8400 Westpark Drive, 2nd Fl
Carmel Clay Parks and Recreation Mclean, VA 22102
1450 N College Avenue United States
Apt 21 (P) (703) 610-9000
Indianapolis, IN 46202 (F) (703) 610-9003
Order Tracking #003710 - 8638809
Balance Due; $0.00
Total Payment Amount; $
James A Dowell Customer ID: 8638809
Site Supervisor Invoice Number: 003540
Carmel Clay Parks and Recreation
1450 N College Avenue Invoice Date: 11/30/2012
Apt 21
Indianapolis, IN 46202
Annual Convention -Two Days: i
Monday/Tuesday Only& Membership $375.00 t 1 $375.00
-Full Membership
Term: 11/30/2012 - 11/29/2013
-2013 NAA Annual Convention(Badge
„Name: Dowell James) _,"..� - ...._._.._.. ._.� . _._ ..._.._._.. ._....."__ _._._...
Subtotal 1 $375.00
Invoice Total $375.00
Amount Paid i $375.00
Balance Due $0.00
Last Payment On This Invoice: Paid by MasterCard ending in 2814 on 11/30/2012 � �
�r 12/3/2012
E-11-1,I i.t'&
Receipt Customer ID: 6109476
Invoice Number: 003500
Invoice Date: 11/30/2012
Please remit payment to:
Jennifer Brown National Afterschool Association
Assistant Manager 8400 Westpark Drive, 2nd Fl
Carmel Clay Parks & Recreation Mclean, VA 22102
1235 Central Park Drive East United States
Carmel, IN 46032 (P) (703) 610-9000
(F) (703) 610-9003
Order Tracking #003670 - 6109476
Balance Duei $0.00
Total Payment Amount= $
Jennifer Brown Customer ID: 6109476
Assistant Manager
Carmel Clay Parks & Recreation Invoice Number: 003500
1235 Central Park Drive East Invoice Date: 11/30/2012
Carmel, IN 46032
a°_rra Mist ?'€adu& d"Jotes „pit Pica,-': -= <Itity A Ain,=iwt
Annual Convention -Two Days: �
Monday/Tuesday Only& Membership $375.00 1 $375.00
_. _ _ _._ ...._.__. ........ _t.....__._._ ,..-------
_........._...... __..._... _._..._..,.
-2013 NAA Annual Convention(Badge
Name: Brown Jennifer)
-Full Membership }
Term: 11/30/2012 - 11/29/2013
Subtotal ( $375.00
Invoice Total f $375.00
Amount Paid $375.00
Balance Due $0.00
Last Payment On This Invoice: Paid by MasterCard ending in 2814 on 11/30/2012
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 2:21 PM
To: Jennifer Brown RECET E D�
Cc: Dawn Koepper ;
Subject: Purchase Confirmation No. 003470 (Ms Jennifer Brown) ( EC 0 3 2012 i
i
i
Dear Ms Jennifer Brown, �T
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 2:17 PM
Purchased By:
Ms Jennifer Brown
Customer ID: 6109476
(317) 573-5240
jbrown(a,carmelclayparks.com
Your confirmation number is: 003470 Please keep this number 1°or anly references,
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days:Monday/Tuesday Only&Membership $375.00 1 $375.00
» Full Membership
» 2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
_ Invoice Total. $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping& Billing lnfornialion
Billing Address:
Jennifer Brown
1235 Central Park Drive East
Carmel IN 46032
United States
i
(317) 573-5240
brown carmelclayparks.com
Payment Information
Payment Amount: 5375.00
Payment Method: C redit ("',I rd
Card Type: s
Card Number: ***********
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: . . Friday, November 30, 2012 2:31 PM
To: Jennifer Hammons
Cc: Dawn Koepper R CT..—iVED
Subject: Purchase Confirmation No. 003490 (Ms Jennifer Hammons)
DEC 032012
Dear Ms Jennifer Hammons, *.
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 2:27 PM
Purchased By:
Ms Jennifer Hammons
Customer ID: 6109474
(317) 573-5240
i h am m ons(ii),ca rmelclayp arks.com
°€ ttr ei)nl'irntati(,)tt tatttnl)er is: 003490 Please keep this k:u tit beH- for only refe irences.
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days:Monday/Tuesday Only&Membership $375.00 1 $375.00
» 2013 NAA Annual Convention
» Full Membership
Subtotal $375.00
Taxes $0.00
Shipping $0.00
. Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping ttillin,„ fnforrnr-N n
Biilint;Address:
Jennifer Hammons
1235 Central Park Drive East
Carmel IN 46032
United States
i
A&
(317) 573-5240
jhammons a,carmelcla-yparks.com
Payment Information
Payment Amount: ` 375,00
Payment Method: Credit ('ter-d
Card Type:
Card Number: ***********
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 2:40 PM
To: Nikeesha Pittman
Cc: Dawn Koepper
Subject: Purchase Confirmation No. 003500 (Ms Nikeesha Pittman) 7DEC2012 i
I
Dear Ms Nikeesha Pittman,
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 2:36 PM
Purchased By:
Ms Nikeesha Pittman
Customer ID: 8633551
(317) 573-5240
npittman(acarmelclayparks.com
Your confirmation ma>rsber is: 003500 PIcase kc�--p this for
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days: Monday/Tuesday Only&Membership $375.00 1 $375.00
» 2013 NAA Annual Convention
» Full Membership _ _
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping& Billing inforrn.€;i€3i1
Bh ina Address:
Nikeesha Pittman
1411 E 116th Street
Carmel IN 46032
United States
i
(317) 573-5240
npittman@cartnelclayparks.com
Payment Information
Payment Amount: 5375.00
Payment Method: Credit Card
Card Type:
Card Number:
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 3:06 PM
To: hmettler @carmelclayparks.com
Cc: Dawn Koepper
7DEC Subject: Purchase Confirmation No. 003550 (Hilary Mettler) 032012
Dear Hilary Mettler, _
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 3:03 PM
Purchased By:
Hilary Mettler
Customer ID: 003800
(317) 573-4026
hmettler(a,carmelclayp arks.com
ourconfirulatierl number is: 003550 :' cast: this number for an
Shopping.Cart Items Amount Quantity Total
Annual Convention-Two Days:Monday/Tuesday Only&Membership $375.00 1 $375.00
» Full Membership - - -
» 2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping t3illiat<� iorf nlroioll
Hittite;Addreis:
Hilary Mettler
1411 E. 116th St
Carmel IN 46032
United States
i
(317) 573-4026
hmettler(c eannelclayparks.com
Pay neat Information
Payment Amount: 5375. $
Payment Method: ("red i t :a rd
Card Type:
Card Number: ************
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 3:15 PM
To: LoToya Neely
Cc: Dawn Koepper �� 7'F,D
Subject: Purchase Confirmation No. 003580 (Latoya Neely)
7DEC 03 2012
Dear Latoya Neely,
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 3:11 PM
Purchased By:
Latoya Neely
Customer ID: 003810
(317) 573-4026
Ineely(&carmelclayparks.com
Your conl°ic°matioa number is: 003580 Plc.-,�sv 8c€a°£a this T.3zm h r "iiii° art
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days:Monday/Tuesday Only&Membership $375.00 1 $375.00
» Full Membership
» 2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
_. Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
491ipping& ll1993it'„)• 31€ ftt-mal€on
(3119€n;;Address:
Latoya Neely
1411 E. 116th St
Carmel IN 46032
United States
i
(317) 573-4026
lneelyn,canuelclayparks.com
Payment Information
Payment Amount: S375,00
Payment Method: 're€lip C;ard
Card Type:
Card Number: ************
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 3:21 PM
To: Shandi Bray LDE
Cc: Dawn Koepper ,
Subject: Purchase Confirmation No. 003600 (Shandi Bray)
3 2012
Dear Shandi Bray, ��_
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 3:18 PM
Purchased By:
Shandi Bray
Customer ID: 003820
(317) 573-4026
sbray(i ,carmelclayparks.com
Your ctrn irmatimi iminher is: 003600 Pie.nsu gee,) this number for anly references.
ences.
Shopping Cart Items Amount Quantity Total
. ....._. . ..... _.
Annual Convention-Two Days: Monday/Tuesday Only&Membership $375.00 1 $375.00
» Full Membership
» 2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping Hilliri- !i€form €ti€ ii
Billincy : ddi es;:
Shandi Bray
1411 E. 116th St
Carmel M 46032
United States
i
(317) 573-4026
sbraygcarmelcl ayparks.com
Payment Information
Payment Amount: S375.0,I)
Payment Method: Credii
Card Type:
Card Number: ***********
Card Expiration Date: 08/2014
Cardholder Name: Shandi Bray
2
Dawn Koepper
From: info @naaweb.org
Sent: Monday, December 03, 2012 9:05 AM
To: psign @carmelclayparks.com
Cc: Dawn Koepper w:
Subject: Purchase Confirmation No. 003740 (Patricia Sign) REC FHI_
AT-"`das
DEC 032012
Dear Patricia Sign,
Thank you for your purchase I
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 12/3/2012 9:00 AM
Purchased By:
Patricia Sign
Customer ID: 003920
(317) 573-4026
psi14n(&carmelclaynarks.com
Your confirmation number is: 003740 Pic ase 14eep this mm ib ,' Im- as-.Y refe -ences.
-Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days: Monday/Tuesday Only&Membership $375.00 1 $375.00
)> Full Membership
» 2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Billing Address:
Patricia Sign
1411 E. 116th St
Carmel IN 46032
United States
i
(317) 573-4026
psin a,carmelclayparks.com
Payment Information
Payment Amount: 53775.00
Payment Method: `rcfj i a Card
Card Type:
Card Number: ***********
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
.From: info @naaweb.org
Sent: Friday, November 30, 2012 2:25 PM
To: Tiffany Buckingham
Cc: Dawn Koepper
Subject: Purchase Confirmation No. 003480 (Ms Tiffany Buckingham)
L0 2012
Dear Ms Tiffany Buckingham, — --
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 2:21 PM
Purchased By:
Ms Tiffany Buckingham
Customer ID: 6109471
(317) 573-5240
tbuckinaham(&carmelclayparks.com
'€tttr e€,ul'irntati€:tt tiut.-t?at;r is: 003480 i'icat.s€ ;w�� tlti, :;b.€rl:lrca 1'€a€ :fc a :°el t�xrtca°
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days: Monday/Tuesday Only&Membership $375.00 1 $375.00
Full Membership - - -
2013 NAA Annual Convention
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total. 1375.00
Payment $375.00
Order Balance $0.00
`~,!tipping& ffilliw-, Infot-ndation
iii€Iin- Address:
Tiffany Buckingham
1235 Central Park Drive East
Carmel fN 46032
United States
i
(31`7) 573-5240
tbuckin hamgcarmelclayparks.com
Payment Information
Payment Amount: S375 00
Payment Method: ,relit card
Card Type:
Card Number: ************
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Dawn Koepper
From: info @naaweb.org
Sent: Friday, November 30, 2012 3:25 PM
To: Meagan Storms
Cc: Dawn Koepper RR C
Subject: Purchase Confirmation No. 003610 (Meagan Storms) ' °'' -`
DEC 0 3 2012
Dear Meagan Storms, BY �
Thank you for your purchase!
For your records, here is a summary of your purchase from The National Afterschool Association.
Date/Time: 11/30/2012 3:23 PM
Purchased By:
Meagan Storms
Customer ID: 003830
(317) 573-4026
mstormsncarmelclayparks.com
'Vot,,r confir°ruation number is: 003610 Please liec o i.i-iis &.#a ;bt! l°or a Y refu '.nces.
Shopping Cart Items Amount Quantity Total
Annual Convention-Two Days:Monday/Tuesday Only&Membership $375.00 1 $375.00
» 2013 NAA Annual Convention
» Full Membership
Subtotal $375.00
Taxes $0.00
Shipping $0.00
Invoice Total $375.00
Grand Total $375.00
Payment $375.00
Order Balance $0.00
Shipping& Biilliral, liiformalion
Billing Address:
Meagan Storms
1411 E. 116th St
Carmel IN 46032
United States
i
(317) 573-4026
mstorms a,carmelclayparks.com
Payment Information
Payment Amount: 107: ,4if;
Payment Method: (,redii C;ard
Card Type:
Card Number: ************WA
Card Expiration Date: 08/2014
Cardholder Name: Dawn Koepper
2
Pacers Sports&Entertainment BANKERS LIFE
FIannah Guess TT
125 S. Guess lvania Street "Ii` LDHO lJ SEj
Indianapolis,IN 46204
Phone:317-917-2824 RECEIPT
Fax:317-917-2899
Ben Johnson Date:. Decembe ,FxVED
Carmel Clay Parks and Rec
1411 E. 116`' DEC 12 2012
Carmel, IN 46032
Account: 1693118
Bankers Life Fieldhouse
Description Price
Indiana Pacers 2012-213 Season
Wednesday, December 19th vs. Utah Jazz
60 Upper Balcony Tickets ($12.72 per ticket) $763.20
AMOUNT DUE: $763.20
TOTAL AMOUNT PAID. $763.20
REMAINING BALANCE $0.00
Payment Method. xxxx 1xxxx 1xxxx 12814 Exp: 08114
Purchase _
Description 12/lq/12-
P.O.# 7�37 PO1�k)
G.L.# (0 Lqq -4: 4,43 7
Budget F„Id I
Line-bescr Nt t
Purchaser Date
Approval Date
Zeview https://resweb.passkey.com/Resweb.do?mode=ep_view_ei&eventI.,.
Reservation Summary Review O
s)3 4
Adults: 1 -Hilton-Americas-Houston cam.
Children: 0 1600 Lamar Street,
Rooms: Houston,TX,77010 ,(y
United States
1 King Bed Executive Floor USD (�2
(2 Nights) jttS l^aO' (J`13a��
Room charges 280.00 Acknowledgement#:326M6CCB l _
Taxes 47_60
Total 327.60 1 King Bed Executive Floor
Total t 327.60 Guest Address Options
Michael W Klitzing 1411 E.116th Street
For a better stay Check in: 01/03/13 7:00 PM Cannel,IN,46032
Check out: 01/05/13 UNITED STATES
Phone:317-450-1250
Spencer's for mklitzing @carmelclayparks.com ))
Steaks and Number of Children:0
Chops
An ultimate dining 1(„� S?S
experience featuring Payment Details and Rates `W O
exceptional food and
Mine and the finest Payment Type Billing Address Rates
prime steaks.
Lobby Bar Credit Card Michael Klitzing Thu Jan 3,2013 - USD 140.00
MasterCard ending in 2421 1411 E.116th Street Fri Jan 4,2013 - USD 140.00
Unwind and catch up Michael Klitzing
with friends and Ex / Carmel,IN 46032
associates with a p'
UNITED STATES
refreshing drink and light
Phone:317-45G-1250
fare.
Skyline Spa Room Policies
Full service spa where . Tax is not included.
you can relax, ■ Fees for extra guests:2nd guest=0,00,3rd guest=25.00,4th guest=25.00
j'• rejuvenate,and be . Children Policy:
pampered. Children 18 years or younger will slay free of charge in their parent's room.
The Cafe Cancellation Policy
A one night room and tax deposit is required at the time of booking with this reservation.Cancellations made within 48 hours
Great food,service and of arrival will forfeit one night's room and tax.
atmosphere,we offer it
all.
Jiva Jive @ 1600
Stop by for coffee and
pastries in the morning
or afternoon
snacks...offering you some of life's little
temptations.
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Line Desc
Purchaser Date
Approval Data -
1 of 1 12/14/2012 12:26 PM
HILTON AMERICAS-HOUSTON
1600 Lamar I Houston,Texas 1 77010
lt® T: 713 739 8000 1 F: 713 739 8007
AMERICAS-HOUSTON W:hllton.COm
NAME AND ADDRESS:
KLITZING, MICHAEL Room: 150431K1
1411 E. 116TH STREET Arrival Date: 1/312013 7:26:OOPM
Departure Date: 1/5/2013
CARMEL, IN 46032 Adult/Child: 1/0
US Room Rate: 140.00
RATE PLAN C-1 NR
H H#
AL:
BONUS AL: CAR:
CONFIRMATION NUMBER: 3494561334
1/5/2013 PAGE 1
DATE_T DESCRIPTION ID REF.NO CHARGES CREDITS BALANCE
i YS
Fitt-TON
12/14!201,2 ' SBIC 8907139 $163.80 1 HHONORS
11312013 GUEST ROOM EVEIT 8934968 $140.00
1/3/2013 STATE TAX 6.0% EVEIT 8934968 $8.40
1/3/2013 SPORTS AUTHORITY TAX EVEIT 8934968 $2.80 U
2.0% OOC
1/3/2013 CITY TAX 9.0% EVEIT 8934968 $12.60
1/4/2013 GUEST ROOM MSAY 8936259 $140.00
1/4/2013 STATE TAX 6.0% MSAY 8936259 $8.40
C.ON(tnD
1/4/2013 SPORTS AUTHORITY TAX MSAY 8936259 $2.80
2.0%
1/412013 CITY TAX 9.0% MSAY 8936259 $12.60
1/5/2013 MMALI 8936733 $163.80
BALANCE $0.00 Hilt n
TITTI,L5 WILL-
ONUO;;RI ETRI E'.
0`i:l�unlrn IM
ACCOUNT NO. DATE OF CHARGE FOLIO NO./CHECK NO.
MC "2421 01/03/2013 1397453 A
CARD MEMBER NAME AUTHORIZATION INITIAL surti_
KLITZING,MICHAEL 030803
ESTABLISHMENT NO.&LOCATION PURCHASES&SERVICES
TAXES HOME®
TIPS&MISC.
CARD MEMBER'S SIGNATURE TOTAL AMOUNT /41mn
Grand Var:rion
MERCHANDISE AND/OR SERVICES PURCHASED ON THIS CARD SHALL NOT BE RESOLD OR RETURNED FORA CASH REFUND, PAYMENT DUE UPON RECEIPT
ILLINOIS
Receipt
Itarn.Connect.Inspire
Please logon to your account and pay online.
Send Checks to:
IPRA
536 East Ave.
La Grange,IL 60525
64843
RM
Michael W.Klitzing
Carmel Clay Parks&Recreation
1411 E.116th Street
Carmel,IN 46032
United States
N,11
Payment Details
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12/14/2012 Dues:Renewal $244.00
t�4aymerit-Method MR
Mastercard
Michael Klitzing 14
1411 E.116th Street
Carmel,IN 46032
US
Paid-for Details
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12/14/2012 5064798 Invoice Member Renewal:Professional $244.00
Kitt O"i
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kT,ota1Wh6iJntjm'-:-!.0 ig!$244i00i,
Fifth ThirdlVendor I Fund 108
Organizati
on & External
Travel Member Field Instruct
expenses dues trips fees _
1125 1125 1081-99 1081-99
V# 354296 4343000 4355300 4343007 43570041
11/30/12 Natl Afterschool Assc �_ $ 375.00
11/30/12 Natl Afterschool Assc �— $ 375.00
11/30/12 Natl Afterschool Assc $ 375.00
11/30/12{Natl Afterschool Assc J $ 375.00
11/30/12 Natl Afterschool Assc $ 375.00 {
11/30/12 Natl Afterschool Assc 375.00
11/30/12 Natl Afterschool Assc $ 375.00
11/30/12 Natl Afterschool Assc $ 375.00
11/30/12 Natl Afterschool Assc _ $ 375.00
11/30/12 Natl Afterschool Assc 1 �_ $ 375.00
11/30/12 Natl Afterschool Assc $ 375.00
11/30/12 Natl Afterschool Assc �_ _ $ 375.00
11/30/12 Natl Afterschool Assc _ $ 375.00
12/06/12 Indiana Pacers $ 763.20
12/1"4/12' IPRA,IL' "; ;: , " ', $ 24400; -h.' 2012 CT P #29274
12714/12 Hilton $ "163.80 2012 CT"" O';#,29277"
j $ 163.80 $ 244.00 $ 763.20 $4,875.0 6,046.00VU
Organizati
on & External
Travel Member Field Instruct
expenses dues trips fees
1125 1125 _ 1081-99 1081-99
43430001 4355300 1 4343007 4357004
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00352832 Fifth Third Bank Terms
P.O. Box 740523
Cincinnati, OH 45274-0523
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/31/12 2798 Travel expenses $ 163.80
12/31/12 2798 Dues $ 244.00
12/31/12 2798 Field trips -- $ 763.20
12/31/12 2798 External instruct $ _4,875.00
Total $ 6,046.00
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
Voucher No. Warrant No.
00352832 Fifth Third Bank Allowed 20
P.O. Box 740523
Cincinnati, OH L<;
In Sum of$
$ 6,046.00
I
ON ACCOUNT OF APPROPRIATION FOR
101 General/ 108 ESE !
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
29277 F 2798 4343000 $ 163.80 1 hereby certify that the attached invoice(s), or
29274 F 2798 4355300 $ 244.00 bill(s) is (are)true and correct and that the
1081-99 2798 4343007 $ 763.20 materials or services itemized thereon for
1081-99 2798 4357004 $ 4,875.00 which charge is made were ordered and
received except
3-Jan 2013
Signature
$ 6,046.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund