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Home My WebLink About220882 06/13/2013 CITY OF CARMEL, INDIANA VENDOR: 080501 Page 1 of 1 ° ONE CIVIC SQUARE CINDY SHEEKS CHECK AMOUNT: $512.12 CARMEL, INDIANA 46032 13791 LAREDO DRIVE CARMEL IN 46032 CHECK NUMBER: 220882 CHECK DATE: 6113/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 366 . 92 HOTEL/PER DIEM 101 5023990 145 . 20 MILEAGE +i i ®T S ■T A ■ E OF INDIANA AN EQUAL OPPORTUNITY EMPLOYER STATE BOARD OF ACCOUNTS 302 WEST WASHINGTON STREET ROOM E418 INDIANAPOLIS,INDIANA 46204-2769 Telephone:(317)232-2513 Fax:(317)232-4711 Web Site:wwNv.in.gov/sboa CERTIFICATE I hereby certify that Cindy Sheeks, Deputy Clerk, City of Carmel, Indiana attended a meeting for City Clerks, City Controllers and City,and Town Clerk-Treasurers in Fort Wayne, Indiana, on June 11 and 12, 2013, called by the State Examiner, pursuant to IC 5-11-14, and is entitled to mileage at a rate per mile determined by the city or town council to the person furnishing the conveyance, for each mile necessarily traveled to the place of the meeting and return, as provided by law. Reimbursement for lodging is also authorized for the nights preceding the meeting dates in an amount not to exceed the hotel's single room rate. Reimbursement for meals purchased while attending the meeting in an amount determined by the city or town council is also authorized. Sincerely, Bruce A. Hartman, CPA State Examiner (This certificate is to be attached to an accounts payable voucher and filed in the Controller's or Clerk- Treasurer's office for payment from the General Fund in the same manner as other claims. No appropriation is required for payment of the expense.) Prescribed by State Board of Accounts General Form No.101 (1955) IQ a MILEAGE CLAIM TO bA �'`%� DR. LU (Governmental Unit) On Account of Appropriation No. 2 for (Office, Board,Department r In titution) DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @ 20 Point Point Start Finish TRAVELED PER MILE r M- Auto License No. TOTALS * 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 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 orrect $ rrect On Account of Appropriation No. �for Disbursing Officer cD Allowed 20 m in the sum of$ o Q (D (D FD m CD (D � (Board or Commission) O (D CD FILED a � Q () 9 O N N Q 0 N ch Cn U) (Official Title) C O " O tYtp,TNF/jsp� S CITY OF CARMEL Expense Report (required for all travel expenses) %NDIAN EXHIBIT A EMPLOYEE NAME: �(.�� w>� �.��'� DEPARTURE DATE: l0 .l7 TIME: � AM / DEPARTMENT: w,t./► I��n y�'l1 Y RETURN DATE: (��/��-�/�?2 TIME: AM M REASON FOR TRAVEL: �� --hr-rAb( oina DESTINATION CITY: 1 EXPENSES ARE FOR (check all that apply): TRAVEL A�B ANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM ✓ Date _ Transportation Gas/Tolls/ Lodging Meals Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 6/10/13 $50.00 $50.00 6/11/13 $50.00 $50.00 6/12/13 $216.92 1 $50.00 $266.92 $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 Total $0.00 $0.00 $0.00 $0.00 $216.92 $0.00 $0.00 $0.00 $0.001 $150.00 $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: Date: City of Carmel Form#ER06 Revision Date 6/13/2013 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 $32.50 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 $32.50 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: City of Carmel Form#ER06 Revision Date 6/13/2013 Page 2 HILTON FORT WAYNE AT THE GRAND WAYNE CONVENTION CENTER �1��®� 1020 South Calhoun Street I Fort Wayne,IN 46802 T: 260 420 1100 1 F: 260 424 7775 FORT WAYNE AT THE GRAND WAYNE CONVENTION CENTER W:hilton.com NAME AND ADDRESS: SHEEKS,CINDY Room: 912/K1 13791 LAREDO DRIVE Arrival Date: 6/10/2013 2:58:OOPM Departure Date: 6/12/2013 CARMEL, IN 46032 US Adult/Child: 1/0 Room Rate: $89.00 RATE PLAN L-G1 HH# 229882016 BLUE AL BONUS AL CAR Confirmation: 3512614388 6/12/2013 PAGE 1 u DATE REFERENCE DESCRIPTION AMOUNT HILTON HHONORS 6/10/2013 2029102 *PARKING 6/10/2013 2029103 GUEST ROOM $89.00 6/10/2013 2029103 OCCUPANCY TAX $6.23 6/10/2013 2029103 STATE TAX $6.23 �g 6/11/2013 2029887 'PARKING $7.00 6/11/2013 2029888 GUEST ROOM $89.00 6/11/2013 2029888 OCCUPANCY TAX $6.23 6/11/2013 2029888 STATE TAX $6.23 C0NRAD WILL BE SETTLED TO'._._ ._. . $216.92 EFFECTIVE BALANCE OF $0.00 Hilton ESTIMATED CURRENCY TOTAL You have earned approximately 1920 Hilton HHonors points for this stay. Hilton HHonors(R)stays are posted within 72 hours of checkout. a check your earnings or book your next stay at more than 3,900 hotels and resorts in 91 countries,please visit HHono Thank you for choosing Hilton!Book your next stay at hilton.com and take advantage of our internet-only Advance Purchase Rates and limited-time special offers! a �`��ilYiY9S 1?34R DATE OF CHARGE FOLIO NO./CHECK NO. Zip-Out Check-Out 454014 A Good Morning ! We hope you enjoyed your stay. With Zip-Out Check-Out AUTHORIZATION INITIAL 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 PURCHASES&SERVICES evening. • For any charges after your account was prepared,you may: TAXES •pay at the time of purchase. •charge purchases to your account,then stop by the Front Desk for an TIPS&MISC. updated statement. •or request an updated statement be mailed to you within two business days. )•{Q E If the statement meets with your approval, simply press the Zip-Out Check-Out TOTAL AMOUNT button on your guest room telephone.Your account will be automatically checked 0.00 out and you may use this statement as your receipt.Feel free to leave your key(s) PAYMENT DUE UPON RECEIPT in the room. Please call the Front Desk if you wish to extend your stay or if you have any questions about your account. srr:d Vacation's i r SPATE OF INDIANA AN EQUAL OPPORTUNITY EfNIPLOYER STATE BOARD OF ACCOUNTS l 302 WEST WASHINGTON STREET ROOM E418 INDIANAPOLIS,INDIANA 46204-2769 Telephone:(317)232-2513 Fax:(3 17)232-4711 Web Site:�t�ww.in.govrshoa TO: All City and Town Clerk-Treasurers,City Clerks and City Controllers DATE: April 26, 2013 SUBJECT: Annual Training School Pursuant to the provisions of IC 5-11-14, the State Board of Accounts will conduct two-day training school on Tuesday and Wednesday, June 11 and 12, 2013, for all City and Town Clerk-Treasurers, City Clerks and City Controllers at the Grand Wayne Center, 120 West Jefferson Boulevard, Fort Wayne, Indiana, which is in downtown Fort Wayne. Registration will be provided each day of the school in the Convention Hall Lobby. Each day of the school will start promptly at 9:00 A.M., E.S.T. The training offered at this school is a joint effort of the State Board of Accounts with the Indiana League of Municipal Clerks and Treasurers. This year's June School is part of the League's Annual Conference which will be held during the week of June 9 through June 13, 2013. The Indiana League of Municipal Clerks and Treasurers has made arrangements for lunch and break refreshments for each day of the meeting. Questions related to registration should be directed to ILMCT, 200 S. Meridian Street, Suite 340, Indianapolis, IN 46225. Please contact Katelyn Storms with IACT at 317 237-6200, Ext. 228, with your questions. The hotel reservation deadline is May 22nd. A registration form is on the ILMCT's website. Please use the form o n the w e b s i t e for making registration arrangements. The discussions at the school will include the duties and responsibilities of your office, federal and state accounting requirements, new legislation, PERF, child labor laws, sales tax, utility receipts tax, common construction wage, and budget preparation. If you have particular questions you would like discussed, please direct them to Charlie Pride of this office prior to June 7, 2013. We are enclosing a tentative agenda for the meeting. As you will note, we plan to have a question and answer session on Wednesday afternoon. A question box will be provided on both days of the school for deposit of your written questions. As provided in IC 5-11-14-1,"the elected official,at the direction of the State Examiner,may require the attendance of: 1. each of his appointed and acting chief deputies or chief assistants: and 2. if the number of deputies or assistants employed: A. does not exceed three(3), one (1) of his appointed and acting deputies or assistants; or B. exceeds three (3), two (2) of his duly appointed acting deputies and assistants." To: All City and Town Clerk-Treasurers,City Clerks and City Controllers April 26, 2013 Page Two Each official,deputy,or assistant attending the conference shall be allowed mileage at a rate per mile set by your city or town council for each mile necessarily traveled in going to and returning from the school. Only one(1)mileage shall be allowed to the official,deputy,or assistant furnishing the conveyance,although they may be transporting more than one (1) person. Each official, deputy or assistant will also be allowed lodging expense for the nights preceding the meeting dates, not to exceed the single room rate each night. Reimbursement for meals purchased while attending the school in an amount determined by the city or town council is also authorized. The State Board of Accounts will certify attendance for the school to each official,deputy, deputies or assistants attending. All payments of lodging, mileage, and meals purchased shall be made by the proper disbursing officer in the manner provided by law on a duly verified claim or voucher to which shall be attached the Certificate of the State Board of Accounts. All payments shall be made from the general fund from any money not otherwise appropriated and without any previous appropriation being made therefore. It is agreeable for other persons (not mentioned in the statute)from your office or other city or town officials to attend the school. However, such other persons must have prior approval from your city or town's governing body and any expenditures must be reimbursed from funds appropriated for this purpose. You are cordially requested to attend the school which has been called in an effort to assist you in properly discharging the duties and responsibilities of your office. Very truly yours, -o Bruce A. Hartman, CPA State Examiner CW P/csc AGENDA STATE BOARD OF ACCOUNTS SCHOOL GRAND WAYNE CENTER FORT WAYNE, INDIANA TUESDAY, JUNE 11, 2013 Registration — Each day in the Anthony Wayne Ballroom Lobby ANTHONY WAYNE BALLROOM 9:00 AM Welcome Mr. Michael H. Bozymski, CPA, Deputy State Examiner Mr. Paul D. Joyce, CPA, Deputy State Examiner State Board of Accounts (SBOA) Mr. Micah Vincent, Commissioner Department of Local Government Finance (DLGF) 9:30 AM New Legislation/Uniform Compliance Guidelines Mr. Charles W. Pride, Sr., CPA (SBOA) 10:15 AM BREAK 10:30 AM Child Labor Laws/Common Construction Wage Requirements Mr. Kenneth Boucher, Director Bureau of Child Labor Indiana Department of Labor 11:30 AM Termination of Utility Service Requirements Mr. Todd A. Austin, CPA (SBOA) 12:00 Noon LUNCH , AGENDA STATE BOARD OF ACCOUNTS SCHOOL GRAND WAYNE CENTER FORT WAYNE, INDIANA WEDNESDAY, JUNE 12, 2013 Registration — Each day in the Anthony Wayne Ballroom Lobby ANTHONY WAYNE BALLROOM 9:00 AM Public Employees Retirement Fund (PERF) Update Mr. Jim Neddeff, Field Services Counselor Indiana Public Retirement System (INPRS) 10:00 AM BREAK 10:30 AM Budget Preparation Guidelines Mr. Dan Jones, Assistant Budget Director (DLGF) 11:30 AM LUNCH 1:00 PM Indiana Department of Revenue (DOR) Regulations Mr. Nick Fetchina, Tax Auditor (DOR) 2:00 PM BREAK 2:15 PM Question and Answer Session/Wrap-up* Mr. Todd A. Austin, CPA (SBOA) Mr. Charles W. Pride, Sr., CPA (SBOA) Mr. Dan Jones (DLGF) Mr. Nick Fetchina (DOR) 3:30 PM ADJOURN *A question box will be provided on both days of the School for deposit of your written questions. 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 LnPurchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoices) or bill(s)) r' fn -�- ' 'G Total Lp' 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 I' LL ALLOWED 20 � IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR 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 A 01 20 -X-Op Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund