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Home My WebLink About222922 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 367453 Page 1 of 1 fONE CIVIC SQUARE MARY EVANS CHECK AMOUNT: $207.93 CARMEL, INDIANA 46032 14831 BIXBY DRIVE WESTFIELD IN 46074 CHECK NUMBER: 222922 CHECK DATE: 8/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4343000 REIMB 8 . 93 TRAVEL FEES & EXPENSE 1091 4357004 REIMB 199 . 00 EXTERNAL INSTRUCT FEE Carmel • Clay Parks&Recreati®n Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense e-4-ee se. Etc. '"c- 7/27/2013 Fitness Conference $199�epo Continuing Education 8/4/2013 S}q,G I `t� 1� ) Fitness Conference $8.93 Lunch All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: V20 AS Employee Name(print) Mary Evans AUG - 7 2013 Address 14831 Bixby Drive Check ° payable to: City, St, Zip We5#ieM IN 46074 --� Signature: ��, Approved byV(/�.�j�^ ° / Date: 8/5/2013 Date: '§'11 b Business Services Division, Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request a Exercise ETC<info @exerciseetc.com> ° July 27,2013 4:12 PM To: Mary Evans<mlmethod @aol.com> Exercise ETC Receipt&Confirmation(#2100-0006-0238) E X E R C I S E RECEIPT AND C®NFXRMAT XON This letter is your receipt and confirms your purchase/registration with Exercise ETC. Please read it carefully and print it out for your records. If you are attending one of our"live"training programs please bring this letter with you to confirm your registration. Please check all of the following details carefully. If there are any problems,changes or concerns please call us at our office at: 1-800- 244-1344 or e-mail us at infoOexerciseetc.com at your first convenience. Date:July-2772013 Invoice#: 2100=0006=0238 Name Quantity Total 7 or 8 Workshops Indianapolis 8/3/2013-8/4/2014 001,002,003,004,005,006,007,008 1 $199.00 Attendee Name: Evans,Mary Sub Total: $199.00 Shipping: $0.00 Tax(6% in FL): $0.00 -=sTotal: X199.:.0.0 Billing Information Mary;Evans Carmel Clay Parks&Recreation 14831 Bixby Drive Westfield,IN 46074 us 3176698344 mlmethod @aol.com Shipping Information Mary:Evans Carmel Clay Parks&Recreation 14831 Bixby Drive Westfield,IN 46074 us Payment Ir`---ation Card Type: ' Last 4 Digits. Expires: 08/2ui5 "Live"Training Program Details: If you are attending one of our"live"training programs, click here for important information: http://exerciseetc.com/file/live-conflrmation-letter,pd Venue Information: If you are attending one of our"live"training programs, click here for important information regarding the location,address, phone number and parking policy at your training location: http://exerciseetc.com/yenues,htmi Refund Policy: Click here for important information regarding our refund policy: Exercise ETC Refund Policy Contact Us: Questions?Concerns?E-mail us at: info(dexerciseetc.com Exercise. Etc. • 1881 NE 26 Street#202 Ft. Lauderdale, FL 33305 Phone: 800-244-1344 • Fax: 954-566-3937 • infoCa)exerciseetc.com j a� 12545 Old Meridian St Carmel, IN 46032 317.844.4448 Date: Aug04'13 01 :10PM Card Type: Acct #: AAAAA. xxxxx, Card Entry: SWIPED Trans Type: PURCHASE Auth Code: 091213 Check: 1564 Table: 101/2 Server: 1024 Brie I Subtotal : 8 . 93 TIP: TOTAL: CUSTOMER COPY THANK YOU E X E R C I S E r 1-800-244-1344 e-mail: info @exerciseetc.com Certificate of Completion This is to document that on 8/3/2013 vas successfully completed a course entitled: Training the Core: 21st Century Core Training Taught by: April Boulter, MS At: Indianapolis, IN GuYAndrews, 9YA C:SC:S*(D Authorized Signature Approved and/or Accepted Bye Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179488 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13643 2.0 NASM 228 0.2 AFAA 2013037R 2.0 NFPT 010104. 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEEO101 2.0 WITS WITS32005ETC 2.0 • The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E MIM 1= 1-800-244-1344 e-mail: info @exerciseetc.com Certificate ®f Completion This is to document that on 8/3/2013 r� successfully completed a course entitled: Exercise for Chronic Diseases: Modifications for Lowe Back Disorders Taught by: Eric Lemkin, MS, CSCS At: Indianapolis, IN GuY-Andrews, WA CSCS*(D Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179168 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13588 2.0 NASM 228 0.2 AFAA 2013037G 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEE0101 2.0 WITS WITS32005ETC 2.0 The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E 1-800-244-1344 e-mail: info @exerciseetc.com (Certificate ®f Completion This is to document that on 8/4/2013 1�cq Em= successfully completed a course entitled: Exercise for Chronic Disabilities: Training with Chronic Shoulder Conditions Taught by: Eric Lemkin, MS, CSCS At: Indianapolis, IN GuY-Xndrews� 9WA CSCS*(D Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179158 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13587 2.0 NASM 228 0.2 AFAA 2013037F 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEE0101 2.0 WITS WITS32005ETC 2.0 o The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E am m 1-800-244-1344 e-mail: info @exerciseetc.com Certificate ®f Completion This is to document that on 8/4/2013 ha LNI v nS successfully completed a course entitled: Designing Wt Mgmt Programs: Diet, Exercise & Weight Mgmt. Past 50 Taught by: April Boulter, MS At: Indianapolis, IN Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CL179028 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA. 13581 2.0 NASM 228 0.2 AFAA 2013037C 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEEO101 2.0 WITS WITS32005ETC 2.0 • The American College of Spoils Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E 1-800-244-1344 e-mail: info @exerciseetc.com Certificate of Completion This is to document that on 8/3/2013 . %ry Ei= successfully completed a course entitled: Designing Cardio Programs: New Directions in Cardio Training Taught by: April Boulter, MS At: Indianapolis, IN GuYAndrews, 91.A C:SCS*(D Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179038 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13577 2.0 NASM 228 0.2 AFAA 2013037B 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEE0101 2.0 WITS WITS32005ETC 2.0 • The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E 1-800-244-1344 e-mail: info @exerciseetc.com Certificate ®f Completion This is to document that on 8/3/2013 �Lv Emma successfully completed a course entitled: Fitness 2013: Understanding Myofascial Release Taught by: Eric Lemkin, MS, CSCS At: Indianapolis, IN GuYAndrews, X4, CSCS*(I) Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179258 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13599 2.0 NASM 228 0.2 AFAA 2013037K 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS 131009 0.2 SCW-EDU 071303 2.0 IFPA ICPEE0101 2.0 WITS WITS32005ETC 2.0 o The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E 1-800-244-1344 e-mail: info @exerciseetc.com Certificate of Completion This is to document that on 8/4/2013 � V successfully completed a course entitled: Exercise for Special Populations: Strategies to Manage Chronic Knee Pain Taught by: Eric Lemkin, MS, CSCS At: Indianapolis, IN GuYAndrews, 9W A, CSCS*(D Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # CECs/ Provider # CEUs Course # CEUs ACE CP179178 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13591 2.0 NASM 228 0.2 AFAA 2013037H 2.0 NFPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEE0101 2.0 WITS WITS32005ETC 2.0 • The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. E X E R C I S E 1-800-244-1344 e-mail: info @exerciseetc.com Certificate ®f Completion This is to document that on 8/4/2013 IA21\4 vas successfully completed a course entitled: Designing Strength Programs: New School Strength Training Taught by: April Boulter, MS At: Indianapolis, IN GuY,Xndrews,? W-A CSCS*(D Authorized Signature Approved and/or Accepted By: Agency Course #/ CECs/ Agency Provider # _CE Cs/ Provider # CEUs Course # CEUs ACE CP179068 0.2 ISSA 981700 2.0 ACSM 650909 2.0 NATA P 118 2.0 AEA 13579 2.0 NASM 228 0.2 AFAA 201303 7 D 2.0 N FPT 010104 2.0 AMFPT 052704 2.0 NSCA-CPT B 1009 0.2 BOC P 118 2.0 NSPA 092304 2.0 CDR XX 021 2.0 SFA 121702 2.0 CSCS B 1009 0.2 SCW-EDU 071303 2.0 IFPA ICPEEO101 2.0 WITS WITS32005ETC 2.0 The American College of Sports Medicine's Professional Education Committee certifies that Exercise ETC meets the criteria for official ACSM Approved Provider status from 2011 —2014. Retain this certificate for four(4)years.Follow all submission guidelines required by your organization. Replacement certificates are available for$5.00 each. 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. Evans, Mary Terms 14831 Bixby Drive Westfield, IN 46074 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO # Amount 7/27/13 Reimb Exercise Etc. Inc. conferernce $ 199.00 8/4/13 Reimb Lunch at conference $ 8.93 Total $ 207.93 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. Evans, Mary Allowed 20 14831 Bixby Drive Westfield, IN 46074 In Sum of$ $ 207.93 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1091 Reimb 4357004 $ 199.00 1 hereby certify that the attached invoice(s), or 1091 Reimb 4343000 $ 8.93 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 8-Aug 2013 Signature $ 207.93 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund