223454 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 079900 Page 1 of 1
`F ONE CIVIC SQUARE GARY DUFEK
CHECK AMOUNT: $97.50
12610 OVERTURE DRIVE
CARMEL, INDIANA 46032
CARMEL IN 46033 CHECK NUMBER: 223454
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4359000 97 . 50 SPECIAL PROJECTS
CITY OF CARMEL Expense Report (required for all travel expenses)
�DIANP=
EMPLOYEE NAME: �c_z's DEPARTURE DATE: TIME: AM
DEPARTMENT: �v,� RETURN DATE: \S - \3 TIME: \'��O AM PM
REASON FOR TRAVEL: C1��`tz�s� DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM ✓
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air-fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
$0.00
8/13/13 $32.50 $32.50
8/14/13 $32.50 $32.50
8/15/13 $32.50 $32.50
$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 $0.001 $0.00 $0.00 $0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $97.50 $0.00 e
DIRECTOR'S STATEME ff penses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date: AUG 2 6 2013
City of Carmel Form#ER06 Revision Date 8/21/2013 Page 1
CITY OF CARMEL
FIRE DEPARTMENT
DATE: August 22, 2013
TO: Cindy Sheeks
FROM: Matthew Hoffman, Fire Chief
Attached you will find several Per Diem Claims and Receipts for the Department members to attend the
Accreditation Hearings in Chicago, IL August 13, 2013 through August 16, 2013.
Please process these claims. If you have any questions, please feel free to contact me.
S r• iss®1eI CHICA ® Room 1403
Folio# 438222
Cashier# 80
323 EAST WACKER DRIVE, Page# = 1 of 1
CHICAGO, IL 60601
Tel:312 565 0565 Fax:312 565 0540 Group Name Center for Public Safety Excellence/IAFC
www.swissotelchicago.com
International Association of Fire Chiefs
Dave Haboush Arrival 08-13-13
1542 Throwbridge High Street Departure 08-16-13
Carmel IN 46032
United States
Date Descrip _Additional
08-13-13 Deposit Transferred at C/I 660.00
08-13-13 Room Charge 189.00
08-13-13 State Room Tax 11.9% 22.49
08-13-13 City Room Tax 4.5% 8.51
08-14-13 Room Charge 189.00
08-14-13 State Room Tax 11.9% 22.49
08-14-13 City Room Tax 4.5% 8.51
08-15-13 Room Charge 189.00
08-15-13 State Room Tax 11.9% 22.49
08-15-13 City Room Tax 4.5% 8.51
Total 660.00 660.00
Balance Due 0.00
TAX Summary
Room 93.00
F&B 0.00
Other 0.00
Total 93.00
Guest Signature X
I agree that my liability for this bill is not waived and agree to be held personally
liable in the event that the indicated person,asociation,or company fails to pay
for any part or the full amount of these charges.
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))
$97.50
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
Gary Dufek
IN SUM OF $
$97.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I I 43-590.00 I $97.50 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
AUG Ic 2 e 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund