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220065 05/21/2013 M CITY OF CARMEL, INDIANA VENDOR: 367170 Page 1 of 1 \� ONE CIVIC SQUARE SCOTT AVERY CARMEL, INDIANA 46032 287 TYNDALE DR CHECK AMOUNT: $240.00 OTALLON MO 63366 CHECK NUMBER: 220065 CHECK DATE: 5121/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4359000 240 . 00 PER DIEM Rry CITY OF CARMEL Expense Report (required for all travel expenses) 'TANp= Elvi NAME�� O�v`�c DEPARTURE DATE: TIME: AM / PM DEPARTMENT: RETURN DATE: 'b -\3 \� TIME: AM / PM TZ o,«moo �°-o-��s� REASON FOR TRAVEL:�� c.�� DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Meals Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem $0.00 $0.00 6/9/13 1 $60.00 $60.00 6/10/13 $60.00 $60.00 6/11/13 $60.00 $60.00 6/12/13 $60.00 $60.00 6/13/13 $60.00 $60.00 $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 $0.001 $0.001 $0.001 $0.001 $0.001 $0.001 $0.001 $0.001 $300.001 $0.00 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: I Date: MAY 2 0 2,013 City of Carmel Form#ER06 Revision Date 5/20/2013 Page 1 CITY OF CARMEL FIRE DEPARTMENT DATE: May 20, 2013 TO: Cindy Sheeks FROM: Matthew Hoffman; Fire Chief Attached you will find Travel Advance Claims for the Center for Public Safety Excellence (CPSE)Peer Assessor Team. This team will be coming to the Fire Department on June 9, 2013 to evaluate the department for accreditation purposes. They will be here beginning June 9`h and leave on June 13th. Per the CPSE Contract that was signed by Chief Smith and Mayor Brainard on November 30, 2011, our department will need to pay for all the Peer Team Expenses. Per Indiana State Board of Accounts requirements,the peer team will be required to turn in all receipts and any funds not used, which in turn will be returned to the Clerk-Treasurers Office. If you have any questions, please feel free to contact me. a 4501 Singer Center Court, Suite 180 Chantilly, VA 20151 Public Safety (866)866-2324 T (703)961-0113 F Excellence www publ;csdetvexcellence.ore LE'T'TER OF AGREEMENT FOR ACCREDITATION The City of Carmel Fire Department hereby agrees, in changing to Applicant Agency status, to conduct and complete the self-assessment process in the pursuit of accreditation through the Center for Public Safety Excellence, Inc. and the Commission on Fire Accreditation International (CFAI). I. Policies and Procedures The Agency also agrees to abide by the policies and procedures of the Center for Public Safety Excellence, Inc. and return to the CPSE any and all, documentation and information pertinent to the self- assessment and accreditation process. II; Payment of Fees The .Agency agrees to ,adhere to and com_ ply with'-the_following' paynients-and costs: A. To pay, the fees associated. with the accreditation process as outlined by'.the Center for Public safety..Exceifence, Inc,.Such fees-shall include: 1. Costs of travel_ for peer assessors assigned _to. _the site' visit. All travel costs shall be paid by the.Agency.and shall- not be handled as'a reimbursement to team members.; 2. Costs of meals and expenses. in_.accordan_ce with .CPSE) policy. Unless such costs exceed...$600:per indiyidual,,,an IRS-1099 form shall not_be:issued. 1 Costs. of lodging for peer,assessors assigned to the .site. Visit. All_ lodging_-shall. be;__arranged; and paid; by._ythe Agency and shall not.be handled as a reimbursemenfeto ,team:'members` 4. EostsA_of travel for :the Team Leader or designated representative to attend the Commission'_meeting and present`_the:Agency<for:_aitcreditation_.i i Commission. Commission Fire Accreditation Professional Chief FireOfFner International Credentialing I Letter of Agreement for Accreditation Page 2 of 3 Such costs shall include, trave[ to, and; ;from the Commission meeting, _lodging for tW nights;;`and ,ger ,diem-in accordancevvith'CPSE policy? III. Non-Refundable fee The Agency understands that the change to Applicant Agency status will only be made upon receipt of the full payment of the Applicant Agency Fee and that fee is non-refundable. IV. Training and Participation The Agency also agrees that it shall adhere to the following training and participation standards: A. An Accreditation Manager shall be required during the period that the Agency seeks and is accredited by the Commission. The Accreditation Manager shall, at a minimum, have taken the Self- Assessment, Standards of Response Coverage (basic) and peer assessor workshop offered by the Commission. B. The Agency shall also agree to participate in the accreditation process by registering with CFAI at least one individual for site visits and who has taken the classes in IV (A) along with the Peer Assessor classes. C. The Agency agrees that it has read, understood, and will comply with all policies and procedures as promulgated by the Commission and its parent Corporation. V. Receipts The Agency shall also indicate if it desires team members to itemize associated costs with receipts or whether it will be utilizing reimbursement in accordance with the policies of CPSE. (Check One) The Agency will require receipts and itemized expenses: The Agency will NOT require receipts and itemized expenses but instead will reimburse in accordance with CPSE policy: X Letter of Agreement for Accreditation Page 3 of 3 Signed: Keith D. Smith, Fire Chief 11-30-2011 f,CEO or ChiefAdminislsadve Officer of Agency Date James C. Brainard, Mayor 11-30-2011 ity/County Idministralvr or Representative ofAuthority Having Jurisdiction Date CFAI Program Manager, Center for Public Safety Excellence Date 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)) 5 days Per Diem- Peer Team $300.00 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. ALLOWED 20 Scott Avery •� --yd,de v IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMpUNT Board Members 1120 I I 43-590.00 I 300.00 1 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 MAY 10 2013 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund