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225390 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 354402 Page 1 of 1 ONE CIVIC SQUARE DAVID HABOUSH CARMEL, INDIANA 46032 1942 TROWBRIDGE HIGH STREET CHECK AMOUNT: $422.21 CARMEL IN 46032 CHECK NUMBER: 225390 CHECK DATE: 10/2312013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231400 75 . 23 GASOLINE 1120 4343003 346 . 98 TRAVEL & LODGING A oc Cqy� �Q_0.T�ERq�A( CITY OF CARMEL Expense Report (required for all travel expenses) ��NDIANA� EMPLOYEE NAME. ��o- �� :� DEPARTURE DATE: TIME: AM / PM DEPARTMENT: �v�� RETURN DATE: TIME: AM/ PM REASON FORT RAVEL `` � � DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT V TRAVEL PER DIEM Date Transportation Gas/Tolls/ Lodging Meals Parkin Misc. Total Air-fare Car Rental Other g g g Breakfast Lunch Dinner Snacks Per Diem $0.00 10/3/13 $95.90 $95.90 10/4/13 $0.00 10/5/13 $0.00 10/6/13 $9.10 $75.23 $241.98 $326.31 $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 $9.101 $75.231 $337.88 $0.00 $0.001 $0.00 $0.001 $0.001 0 DIRECTOR'S STATEME I her y Arm that all expenses listed conform to the City's travel policy and are within m department's appropriated budget. C _ 21 2013 Director Signature: / Date: City of Carmel Form#ER06 Revision Date 10/14/2013 Page 1 C"ITY OF CARMEL FIRE DEPARTMENT DATE: October 14, 2013 TO: Cindy Sheeks FROM: Matthew Hoffman, Fire Chief Attached you will find a reimbursement claim for expenses incurred while attending the National Fallen Firefighters Memorial in Maryland. Originally lodging was to be at the National Fire Academy, however due to the Government shutdown, AC Haboush, FF Reecer had to provide their own lodging. Meals were still provided. If you have any questions, please feel free to contact me. Thank you. Family Escort Application - 2013 MW- RegOnline Page 1 of 2 I-EN 0 cy� NATIONAL FALLEN FIREFIGHTERS z MEMORIAL WEEKEND October 4 - 65 2013 0 FOR MORE INFORMATION VISIT: Weekend.FireHero.org 241 3 Receipt Receipt Number: 1243315-57504728 Registration ID: 57504728 Registration Date: 6/28/2013 Receipt Date: 6/28/2013 Issued By: National Fallen Firefighters Foundation Event: Family Escort Application -2013 MW DatelTime: Friday, October 04, 2013 - Sunday, October 06, 2013 Registrants Name Registration Type ID David Haboush 57504728 General Application Billing information David Haboush 1942 Trowbridge High St. Carmel, IN 46032 United States Personal Info David Haboush 2 Civic Sq. Carmel, IN 46032 3177051942 dhaboush@carmel.in.gov Fees Fee (quantity Unit Price Amount https://www.regonline.com/register/invoice.a spx?Eventld=1243315&Attendeeld=geHG4NaUTiK... 812712013 Family Escort Application -2013 MW - RegOnline Page 2 of 2 Fee Quantity Unit Price Amount Fee All Meals 1 $75.75 $75.75 Subtotal: $75.75 Total: $75.75 Transactions . Transaction Type Date Amount Balance Transaction Amount 8/26/2013 $75.75 $75.75 Online Credit Card Payment Details 8/26/2013 ($75.75) $0.00 Current Balance: $0.00 Payment Method Payment Method: Credit Card (Discover) The online credit card payment for this event will be listed on your credit card statement with the name NFFF. https://www.regonIine.com/register/invoice.aspx'?Event]d=1243315&Attendeeld=geNG4NaUTiK... 8/27/2013 Family Escort Application - 2013 MW - RegOnline Page 1 of 2 NATIONAL FALLEN FIREFIGHTERS z �� MEMORIAL WEEKEND October 4 - 6, 2013 FOR MORE INFORMATION VISIT: Weekend.Fire Nero org 2013 Receipt Receipt Number: 1243315-57505872 Registration ID: 57505872 Registration Date: 6128/2013 Receipt Date: 6/28/2013 Issued By: National Fallen Firefighters Foundation Event: Family Escort Application -2013 MW Date/Time: Friday, October 04, 2013 - Sunday, October 06, 2013 Re istrants Name Registration Type ID Jason Reecer 57505872 General Application Billing Information Jason Reecer 13375 a 266th st Arcadia, IN 46030 United States 317-984-8319 jreecer @carmel.in.gov Fees Fee Quantity Unit Price Amount Fee All Meals 1 $75.75 $75.75 Subtotal: $75.75 https://www.regonIine.conV register/invoice.aspx?EventId=124331 5R Attendee1d=Xf-W K 11RgS... 8/27/2013 BSENHOVVER HOTEL (717) ]]4'81Z1 "6]4EMM|TS8URGROAD ��ETTY�OURG, P4 17325 [/U 10/06/2013 0716ANJR Room # 130'4 [on[# 17278 [,egsteredTo: Arrival 10/04/13 Departure 10/06/13 }:aboush, David �Y4Zthmwbridge high st Room Type QQE'0«eenQoeen � ARMEL' IN 46032 Guests I / U Payment (1,17) 716-4412 Acct XXxx'^^^X'XXXX 10/04/13 TK R[ ROOM [HRG REVENUE $109.00 10/04/13 TK 9 CITY TAX $5.45 10/04/13 TK 91 STATE TAX $6.54 10/05/13 TK R[ R0OM[HRG REVENUE $109.00 10/05/13 TK 9 CITY TAX $5.45 10/05/13 TK 91 STATE TAX $6.54 10/06/13 JR D[ PAYMENT —~ $241.93' Balance Due $0.00 -1 HE UNDERSIGNED GUEST AGREES TO PAY THE AMOUNT INDICATED ON THE BALANCE DUE PORTION OF THIS INVOICE. |� THE [HARGES ARE TO BE BILLED TO A THIRD PARTY, THE UNDERSIGNED AGREES TO BE PERSONALLY LIABLE FOR PAYMENT OF THE CHARGES IN THE EVENT THAT THE INDICATED THIRD PARTY, PERSON, COMPANY OR ASSOCIATION FAILS TO PAY FOR ANY PART DR THE FULL AMOUNT OF SUCH CHARGES. Account: 307856545 C omfort Inr�.(OH415) Date: 10/4/13 500 Monroe St. Room: 233 sGm e ' Zanesville,OH 43701-3884 Arrival Date: 10/3/13 (740)454-4144 Departure Date: 10/4/13 B Y C H 01 C E H O T E L S GM.OH415@choicehotels.com Check In Time: 10/3/13 9:47 PM Check Out Time: 10/4/13 9:43 AM Haboush, David Rewards Program ID: GP-DGH03052 2 Civic Square You were checked out by: bmahon0.oh415 Carmel, IN 45032 You were checked in by: kfergu0.o'(,i415 Total Balance Due: 0.00 10/3/13 Room Charge #233 Haboush, David 83.00 10/3/13 City/County Tax 5.81 10/3/13 Sales/Misc tax 6.02 10/3/13 Safe w/Itd Warranty 1.00 10/3/13 Sales/Misc tax 0.07 10/4/13 (95.90) XXXXXXXXXXX, Room Charge 83.00 City/County Tax 5.81 Sales/Misc tax 6.09 Discover (95.90) — --- -- —- - Safe vv/Itd-I.p/arrRnty Balance Due: 0.00 This rate is eligible for partner rewards.If this rate is changed,you may no longer be entitled to Choice Privileges points. If payment by credit card, I agree to pay the above total charge amount according to the card issuer agreement. x CHOICE privileges, a Congratulations. You are earning Choice Privileges Points for this stay. VOUCHER NO. WARRANT NO. ALLOWED 20 Dave Haboush IN SUM OF $ $422.21 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-430.03 $346.98 1 hereby certify that the attached invoice(s), or 1120 42-314.00 $75.23 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 OCT 24 2013 0 Fire Chief 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)) $346.98 $75.23 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