225893 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
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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
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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
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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
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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