HomeMy WebLinkAbout225148 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 360074 Page 1 of 1
ONE CIVIC SQUARE SUE WOLFGANG CHECK AMOUNT: $124.63
CARMEL, INDIANA 46032 C/O HUMAN RESOURCES
ONE CIVIC SO CHECK NUMBER: 225148
CARMEL IN 46032
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4343002 10 . 01 . 13 124 . 63 EXTERNAL TRAINING TRA
of CAR
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: SUSAN WOLFGANG DEPARTURE DATE: 9/30/2013 TIME: 8:30 AM/ PM
DEPARTMENT: HUMAN RESOURCES RETURN DATE: 1-Oct TIME: 4:45 AM / PM
REASON FOR TRAVEL: WELLNESS CONFERENCE DESTINATION CITY: INDIANAPOLIS
TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT X PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
9/30/13 $14.00 $9.62 $2762
10/1/13 $14.00 $14.00
$0.00
................
$0':00
$0.00
$0.00
$0.00.
$0.00
$0.0.0
$0!.00
0
$0.0
...._..............
$0'x00
$0:00
$0:00
. __._..__.
$0.00
i $0;00
$0.00
I $0.00
$0.00
y— $0.00
0A0
Totall $0.00 $0.001 $0.001 $28.001 $0.001 $0.001 $9.621 $0:00 $0.00 $0.001 $0.001,''', $37,y62
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 10/2/2013 Page 1
AFFIDAVIT
I hereby affirm my payment of $14 for parking fees at Denison Parking Pan
American Garage, 201 South Capitol Avenue, Indianapolis, on October 1, 2013. 1
neglected to get a receipt from the garage on that date.
I was in a work-related, 2-day seminar (Indiana Health and Wellness Summit) at
the Crown Plaza Hotel at Union Station, Indianapolis.
jzaaln October 2, 2013
Susan E. Wolfgang V 61
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201 S. Meridian St
URRENT o Indianapolis, IN 46225 j 317-638-9464
Totall F62' A.C10
M p�.'� S 14.01A- Date: Sep30'13 01 :17PM
LAS� i IV
$
Card Type:
age lule Acct XXXXXXXXXXI
THORK YOU Card Entry: SWIPED
Trans Type: PURCHASE
Trans Key: AIA010176605375
Auth Code: 397751
Check: 2029
Table: 51/1
Server: 1019 Autumn W
Subtotal : 7 . 62
Tip:_ a
Total : 6-2—
CUSTOMER COPY
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SEPT. 30 OCT. 1 , 2013
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UNION • INDIANAPOLIS
PRESENTED. BY: - 1N PARiTNERSHIP WITHi
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CONTINUING EDUCATION
• CPE: Up to 13.2 credits. This is a self-auditing credit; the
Indiana Board of Professional Licensing does not pre-
approve courses for continuing education. A confirmation of
• ®® attendance will be emailed to you upon request (see the
11 • ° •• • - "Summit Evaluation" section on this page).
• ®® / I • ,® • General CEU: Up to 1.1. This is a self-auditing credit; a
confirmation of attendance will be emailed to you upon
1 • request (see the "Summit Evaluation" section).
• Insurance CE: Workshops Four and Five on September 30
have been approved for 3 hours of insurance CE credit each.
• Human Resource Specialist Certificate: up to two credits
toward the completion of your Indiana Chamber Human
1 ® • •• Resources Specialist Certificate.
® .• • HRCI: the summit is approved for up to 1:1 recertification
credit hours towards PHR, SPHR, and GPHR through the HR
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Certification Institute. Please see the certification credit
0 e •. . • - .. checklist in your registration bag.
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s ® •v SUMMIT MATERIALS
• 1 e e• a -. Speaker materials are available for download
at www.IndianoWellnessSummit.com. As
additional speaker materials are received, they
0® = -• will be added to the web site post-summit.
SUMMIT EVALUATION
The summit evaluation is electronic and will be emailed to you
on October 2, 2013. In order to receive a confirmation of
attendance, you will need to fill out the evaluation and request
• - • • : -. the confirmation email.
SESSION SKILL LEVEL
• Basic (B): Defined as having little to no experience in the topic
' /® • " • • Intermediate (1): Defined as having moderate experience in
• • the topic; not yet an expert
• •• • • Advanced (A): Defined as having a solid level of knowledge
of the topic
PRESENTED BY
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• Less than 100
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o_T p�L�� o r 250 or more
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Prescribed by State Board of Accounts: General Form No.101(1955)
l�^T MILEAGE CLAIM ci
TO C�JuC'_ (/� � DR.
Governmental,Unit)
On Account of Appropriation No. for
toffice,Board,Department or Institution
DATE FROM TO ODOMETER READING' NATURE OF BUSINESS AUTO MILES MILEAGE @ •��5
2013 Point Point Start Finish TRAVELED PER MILE
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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 justand correct,that the amount claimed is legally due,after
allowing all just/credits,and that no part of the same has been paid.
.Date
(013
By
Claim No,—Wmant No. I have exarriined the within clairn 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 correct
$ 1,incorrect
On Account of Appropriation No--for
Disbirrsing Officer
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Wolfgang, Sue
IN SUM OF $
Employee
$124.63
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1201 10.01.13 43-430.02 $37.62 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1201 10.02.13 43-430.02 $87.01
materials or services itemized thereon for
which charge is made were ordered and
received except
Mon/dray, October 07, 2013
L�
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
10/01/13 10.01.13 Wellness Conference $37.62
10/02/13 10.02.13 milegage 1/24/13-10/1/13 $87.01
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