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Home My WebLink About225893 11/05/2013 "*F CITY OF CARMEL, INDIANA VENDOR: 359018 Page 1 of 1 ONE CIVIC SQUARE KATHERINE MALLOY CHECK AMOUNT: $692.40 CARMEL, INDIANA 46032 CHECK NUMBER: 225893 CHECK DATE: 11/5/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 692 .40 TRAINING SEMINARS `y'oc CAq CITY OF CARMEL Expense Report (required for all travel expenses) EMPLOYEE NAME: KATHERINE E. MALLOY DEPARTURE DATE: 9/15/2013 TIME: 7:00 A M QPM DEPARTMENT: CARMEL POLICE DEPT RETURN DATE: 9/20/2013 TIME: 12:00 AM PM REASON FOR TRAVEL: K-9 UNIT RE-CERTIFICATION DESTINATION CITY: VALPARAISO, IN EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM X Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 9/15/13 $25.00 $25.00 9/16/13 $50.00 $50.00 9/17/13 $50.00 $50.00 9/18/13 $50.00 $50.00 9/19/13 $50.00 $50.00 9/20/13 $25.00 $25.00 $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 1 $0.00 $0.001 $0.00 $0.00 $0.00 $0.00 $0.001 $0.00 $0,001 $250.00 ;et.DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated b Director Signature: Date: V` City of Carmel Form#ER06 Revision Date 10/22/2013 a et iW 2 09-20-13 Brian Schmidt Folio No. Room No. 208 3 Civic Sq. A/R Number Arrival 09-15-13 Carmel IN 46032 Group Code NAP Departure 09-20-13 us Company NAPWDA Conf. No. 66365339 Membership No. Rate Code Invoice No. Page No. : 1 of 1 Date I Description I Charges I Credits 09-15-13 *Accommodation 79.00 09-15-13 Sales Tax-Room 5.53 09-15-13 Occupancy Tax-Room 3.95 09-16-13 *Accommodation 79.00 (19-16-13 Sales Tax-Room 5.53 09-•16-13 Occupancy Tax-Room 3.95 09.17-13 *Accommodation 79.00 09-17-13 Sales Tax-Room 5.53 09-17-13 Occupancy Tax-Room 3.95 09-18-13 *Accommodation 79.00 09-•18-13 Sales Tax-Room 5.53 09-18-13 Occupancy Tax- Room 3.95 09-19-13 *Accommodation 79.00 09-19-13 Sales Tax-Room 5.53 09-19-13 Occupancy Tax-Room 3.95 09-20-13 442.40 Total 442.40 442.40 Balance 0.00 Guest Signature: I have received the goods and/or services in the amount shown heron. I agree that my liablity for this bill is not waived and agree to be held personally liable in the event that the indicated person,company,or associate fails to pay for any part or the full amount of these charges.If a credit card charge,I further agree to perform the obligations set forth in the cardholder's agreement with the issuer. Holiday Inn Express Hotel&Suites 1251 Silhavy Road Valparaiso, IN 46385 Telephone: (219)464-9395 Fax: (219)464-9365 BankAmericard Rewardea Bank®f Ai11eriC8 w KATHERINE E MALLOY Account Number September 5-October 3, 2013 •o a -e • r Transaction Posting Reference Account Data, Date Description Number Number Amount Total Purchases and Adjustments 9/,21 •, 09/23'._ HOL'IDQY INN VALPARAISO VALPA_ RAISO IN 0074 1470 442.40 ARRIVAL DATE 9/15/13 .. `'-`' 2013 NAPWDA Indiana Fall State Workshop September 16`t'- 20", 2013 REGISTRATION FORM (PLEASE PRINT LEGIBLE) Name: Home Address: 1"619 City: Q0b(FSv Ile State: IU Zip Code: L4&o(,:v Home Phone: 3t7 5:71 - 25oo E Mail: K �.iloy C C�r�+ael . n.q�,✓ _ Agency: Agency Address: 3 (.;v;c Sv,��✓e City: ( ri"i State: to Zip Code: Lltco7Z Work Phone: 3i7 ) 5-1t - 25cc, NAPWDA Workshop Waiver: The undersigned participant recognizes the possibility of injury occurring as a result of his/her participation in the K9 Workshop. I furthermore state that my canine and I are in a physical condition . necessary to be able to participate in the events, as needed for training and certification purposes. I hereby waive and relinquish the North American Police Work Dog Association, further referred to as NAPWDA, the Valparaiso Police Department and the County of' Porter, City of Valparaiso, their employee's, affiliates, sponsors, organizers, and or all participants,for any injury, mental or physical, to myself or my canine. I also agree to abide by all rules and regulations as set forth by NAPWDA and the event organizers. I furthermore will accept responsibility for any damage caused by my canine or myself to any and all property, persons and to include the hotel accommodations and or any training venue. Date: � / i e / eu,5 Sign Name: Print Name: {�Q�1 ;;, N1�,ti\Vy Current NAPWDA Member? Yes ✓ No K9 Breed: `- lW K9 Name: K9 Age: �1 Type K9(check an appropriate descrip(ions)Patrol X Nareoti Explosive_ Cadaver_ SAR _ K9'S Working Ability: Beginner_ Intermediate i Advanced — Handler's Ability: Beginner_Intermediate�Advanced _ Purpose of Attending Workshop (check at least one): Training X Certification (New) _ Certification (Renewal) V If certifying, LIST ALL areas of certification you will be attempting: Workshop Fee: The cost of the workshop is $125.00 per K9 team. A K9 team is 1 handler with I dog. There is an additional workshop fee of$75.00 per additional dog for any K9 Handler wishing to train or test with an additional dog. Make workshop fee checks pavable to Valparaiso Fraternal Order of Police Lodge#76. Mail checks and completed Registration Form in before September 1, 2013. No refunds at all offer September 1, 2013. Mail Registration to: Valparaiso Police Department 355 Washington St Valparaiso, IN., 46383 Attention: Todd Kobitz Mail checks and completed Registration Form in before September 1, 2013.No refunds fit I&((gtey Se jp%bev ,N13. ,r �t 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)) 10/31/13 K9 recertification $692.40 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. Katherine E. Malloy ALLOWED 20 IN SUM OF $ $692.40 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 210 -570.00 $692.40 I hereby certify that the attached invoice(s), or _ I I 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 Thursday October 31, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund