HomeMy WebLinkAbout219403 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 357005 Page 1 of 1
ONE CIVIC SQUARE DAVID LITTLEJOHN
CARMEL, INDIANA 46032 4840 N.GUILFORD AVENUE CHECK AMOUNT: $325.00
INDIANAPOLIS IN 46205 CHECK NUMBER: 219403
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 325 . 00 TRAVEL PER DIEMS
4��Y xr CA-1 .
CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: _David Littlejohn DEPARTURE DATE: 4/13/2013 TIME: 12:00 PM
DEPARTMENT: DOCS RETURN DATE: 4/17/2013 TIME: 5:00 PM
REASON FOR TRAVEL: APA Conference' DESTINATION CITY: Chicago IL
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM X_
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air-fare Car Rental Other 9 Breakfast Lunch Dinner Snacks Per Diem
4/13/13 $65.00 $65.00
4/14/13 $65.00 $65.00
4/15/13 $65.00 $65.00
4/16/13 $65.00 $65.00
4/17/13 $65.00 $65.00
$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 $0.001 $0.001 $0.00 $0.00 $0.00 $0.001 $0.00 $325.00 $0.00 0 0
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 4/18/2013 Page 1
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 $30 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 $30 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: _� Ig
City of Carmel Form#ER06 Revision Date 4/18/2013 Page 2
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Order Confirmation
Order #APA7236.CART
Order Sumrnary:
Product Quantity Price
2013 APA National Planning Conference 1 $695.00
Exhibitor Meet and Greet 1 $0.00
Expo Lunde 1 $0.00
PowerPoint Presentations 1 $0.00 r
I
$69s,00'total
Credit Card Payment:
Type of Card
Name on Card Angelina Conn
Credit Card#
Expiration Date 2013-03
Billing Address Line 1 1340 N Dequinry St
Billing Address Line 2
City Indianapolis
State J Province IN
Country United States
Zip/Postal Code 46201
Continue to My Account
https://www.plaiining.ora/cart/reccipt/?OrderID=7236 12/18/2012