2012-14 O'Neill Expense Reports

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L'ivision of ControllerMONTGOi\ilERY COUf\JTY PUBLIC SCHOOLS

Hockville, Maryiand 20850

MOf\JTHLY STATEMENT OF MILEAGEFOR USE OF PRiV.l\TE VEH!CLE

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Ba3e School Location New: 0 Yes 0 No

Da1e Purpose of Trip INo. of Miles Parking, Tolls, Public Transporiatio11·

1Reimbursable A.mouni I liem l

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9 1 4-;µ_i_v LUDete -r

LLU03te

1 220-2, Rev. 8/07

Division of ControllerMONTGOMERY COUNTY PUBLIC SCHOOLS

Rockville, Maryland 20850

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MONTHLY STATEMENT OF MILEAGEFOR USE OF PRIVATE VEHICLE

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INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Trc.vel.) Lisi all official stops in date order.

Employee ID No. [0-·1 0 I 0 I O / r I I I I(First) (Middle)

Patricia

(Apt. No.)

O'Neill

Name (Last)

Address (Street No.) (Street)

Purpose of Trip

I '7;:<,~~1 ·1 2? l7'J

(City)

Date Destination

(State)

Maryland

Base School Location New: 0 Yes CZfNo

Board of Education

No. Miles to and from Home and Base Locatio:

22.0

Job Title

Board Member

(ZIP Code) I Submitted for Month oUkNUse one form for each month

No. of MilesReimbursable

, i'iT--z::::~ "-;J 1 c~ ~ _n I

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Total This Page 60{~1Total neverse Page I 1L=GRAND TOTAL I f)!J ~! I

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~APPROVED

Signazvr' PTttrtipal/Supervisor

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~C? ~Signature,Ac~nager~2--r~

MCPS Form 220-2, Rev. 8/07

ACCOUNT NUMBER

Parking, Tolls, Public Transportation"

ItemAmount

For Accounting Use Only

----miles @ _

Other _

Pa.y.

~-d+Y,~ L<f l<f

Date

.·~<4·.-~-,

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Division of; ControllerMONTGOMERY COUf\!TY PUBLIC SCHOOLS


k,;.. J.,.-, . ~"·""'*~.~•.•>•• '""'--"·'-·•·»···••o ,. •ef.-•o P· ~ '0,.-t,••4•.•Ji\ ·•.•\·-- . .., -· '"""H"C"""ii

IMONTHLY STATEMENT OF MiLEAGEFOR USE OF PRIVATE VEHICLE I

···""6·.:..,0-24"'· ·--"·""''r - . ...-'-j•,• ;:; ;:, • §·.•.r,,.,,.~••, il '~@t•§ys-,. ;,Q?:J,,,,g:;; .. ·~«9""-'•'+# ·•~~~-INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors wili forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Employee 10 No. f () I O I O I O I I I I I IName (Last) (First) (Middle)

O'Neili Patricia

Address (Street No.) (Street) (Apt. No.)

(City) (State) (ZIP Code)

Maryland

Date Destination I Purpose of Trip I RN?.obfMilebslaim ursa e

,

Base School Location New:0 Yes (Zf No

Board of Education

No. Miles to and from Home and Base l.ocatioi

22.0

Job Tille

Board Member

Submitted for Month1) e._,r-Use one form for each mo'nfh'

Parking, Tolls, Public Transportation"

Amount I Item

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miles@

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OtherPay.

Signat4re,\'f'rincipa//Supetvisor

,,,,,--- ,,,,

Total This Page

Total Reverse Page'APPROPRIATE RECEIPTS

MUST BE ATTACHED GRAND TOTAL

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~PROVED 7172_ ~ J/i LLiLfDate77 ygr®u~Account Nlanager

ACCOUNT NUMBER


PURCHASING CARDCard Member Transaction Log

Office of the Chief Operating OfficerDepartment of Materials Management

MONTGOMERY COUNTY PUBLICSCHOOLS • Rockville, Maryland 20850~

MCPS Form 234-21June 2009

Card member name Patricia O'NeillSchool/office name B~o~a1~-d~o~f~E~-·~dt~1c~n~t~io:n~----------------------:-------------=============

For the period: From September 29, 2013

Work location CESC. Room J 23

To October 28, 2013 USIESEPARATE LOG FOR EACH ACCOUNT

Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be identified.) (03, 05, etc.)

I0/03/2013 J 0/04/2013 $54.36 Clarion Fontainbleau Hotel, Lunch during MABE Annual Conf. - 10/28/2013 504091

Breakers Pub, O.C., tvlD O'Neill, Hixson, Madalena, Kaiser

l0/07/20 J 3 10/07/2013 $151.53 Clarion Fontainbleau Hotel, O.C., MD Lodging, MABE Annual Conference l0/28/2013 504091

l 0/02/20 l3 -10/06/2013

Total $205.89

CERTUFICATION STATEMENT

I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresenratiorj.oe-omqsion from this log maybe grounds for cancellationof:} purchase card privilege and/or disciplinary action. .

~-~-= ~ ~ -1L1-21 j,3 ~ L 9=· JL.1_/fu_fl5tur;,ea;d Mi Date Sianature.AVInaOfficial Da Le °J

·------ -· --·

Al1

Corporate PurchasingCardmember Report

,,a.redFor,ATRICIA O'NEILL

MCPS MDTAX 3000123-5

AccountNumoor ·closingDate10/28/13

'~o'o"'cc0

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PreviousBalance$ NewCharges$ Other Oeblts$ Payments$ Other Creons$

I o. oo I I 205.89 I I o. oo 11-==·===::.:=::::::::=:::::.·::::::.=...=·~:':ggJ 1:-·.:·:.,=_:=,::=_':=::.·=:.-:::=::::-·:::=~·-~~:I

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For important informationregarding your accountrefer to page 2.

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See Page 3 For A Notice Of Changes To Your Agreement<(

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For your records only - do not pay.

For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Se:-viceat 1-800AG2-4920.

;;o Card Numbe, ReierenceCode Amount S

AclaYity Dale reileolsei:ner transactionor postingdate

10/04/13 CLABION RESORT FONTA OCEAN CITY MDREF# 0 4105243535 10/03/13~~~~~~-CLARION RESORT HOTEL OCEAN CITY MDFOL# 684822 LODGING 10/07/13ARRIVAL DATE DEPARTURE DATE10/02/13 10/06/13 00ROOM RATE $145.00ROC NUMBER 684822

10/07/13

54._3_6_.

151.53

Total for PATRICIA O'NEILL 205.890.00

New Charqes/Other DebitsPayments/Other Credits

Do not staple or use paper clipsPayment Coupon

t-,...,...,.,...,, •• ,1\/umber

N

"'00

PATRICIA O'NEILLMCPS MDTAX 3000123~5850 HUNGERFORD RM123ROCKVILLE MD"'"'cNc 20850-1718

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Chee!{ here if address,telephone number, ore-mail address haschanged. Note changes onreverse side .

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Clarion Fontainebleau Hotel10100 Coastal HighwayOcean City, MD 21842United StatesTel: 410-524-3535 Fax: 410-524-3834

Patricia O'NeillMontgomery County Bd Of Ed850 Hungerford DriveRockville, MD 20850United States

Page Number :,.L

Guest Number: 684822Folio ID : ANo. Of Guest: lRoom Number : 1211Room Rate : 145.00Club Account:

Arrive Date: 10-02-13 09:29Depart Date: 10-06-13 08:12

Email: [email protected] - Mabe

Copy Invoice

Fontainebleau Hotel l0-06-i3 08:14 VALERIEH

Date Reference Description

10-02-13 DEPOSIT Deposit Applied10-02-13 RT1211 Room10-02-13 RT1211 4.5% Occupancy Tax10-03-13 RT1211 Room10-03-13 RT1211 4.5% Occupancy Tax10-06-13 AX American Express

** Total

*** Balance

Charges Credits

-151.53145.00

6.53145.00

6.53-151.53

303.06 -303.06

-0,00

EXPENSE STJlVJMARYREPORT

Date Room&Tax Telephone Food&Bev Other Total Payment10-02-13 151.53 0.00 0.00 -151.53 0.00 0.0010-03-13 151.53 0.00 0.00 0.00 151.53 0.0010-06-13 0.00 0.00 0.00 0.00 0.00 -151.53

--~------- ---------- ---------- ---------- ---------- ----------Total 303.06 0.00 0.00 -151.53 151.53 -151.53

~i'•"··~·~··-<-·-·~=-·,...•.-••.~ ·->..----·-.-~-..,,.·~ . - ' ..'·"- ,_,,,."----·. ··-"Division of Controller

MONTGOMERY COUNTY PUBUC SCHOOLSRockville, Maryland 20850

I! ..._ "~·;.. ees ~.3, .--r.:;t--~~,,;..-;..,c ;;;;; -·

MONTHLY STATEMENT OF MILEAGEFOR USE OF PRIVATE VEHICLE

·--·=--·-~.•··==-·9'4·--9'---» ·--·6~·-·---•.• ~J-- • -··•..r1

· 1

11

Base School Location New: D Yes CZf No

INSTRUCTIONS: This form. should be ·submitted to your immediate supervisor by th? third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Diviston of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Board of Education

No. Miles to and from Home and Base l.ocatior

22.0

Job Title

Board Member

Employee ID No. I 0 I 0 I 0 I 0 I I I I I lNe.me {Last} (First) (Middle)

O'Neill Patricia

Address (Street No.) (Street) (Apt. No.}

(City} (Staie) (ZIP Code)Maryland

/ No ..of MilesDate Destination I Purpose of Trip Reimbursable

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Submittedfor Month of: 'fJ \) v1Use one form for each month

Parking, Tolls, Public Transportation·

GRAND TOTAL

L3'd-.Total Reverse Page

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It /,ljp M-~~

Amount I Item

f\'f r-, (.?I~~

Total This Page

~Pf)~Signature, Employee ~

~~'~Signatute':'iPrincipal/Supervisor

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.ACCOUNT NUMBER _

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•APPROPRIATE RECEIPTSMUST BE ATTACHED

tMCPS Form 220-2, Rev. 8/07

,.

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Division of Controller 'MONTGOMERY COUNTY PUBLJC SCHOOLS MONTHLY STATEMEf\lT OF MILEAGE I

Rockville, Maryland 20850 FOR USE OF PRIVATE VEHICLEI

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INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month ..Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) Lisi all official stops in date order.

Base School Location New:0 Yes v.f No

IEmployee ID No. I 0 I 0 I 0 I 0 I 5 I 3 I 1 I 4 I 6 I Board of EducationI

Name (Last) (First) (Middle) No. Miles to and irom Home and Base l.ocatiot

O'Neill Patricia 22.0

Address (Street No.) (Street) (Apt. No.) Job Title6716 Landon Lane Board Member

··---·· -··(City) (State) (ZIP Code) Submitted for Monthoi:oe:r- ,

Bethesda Maryland 20817 Use one form for each month

No. of Miles Parking, Tolls, Public Transportation·Date Destination Purpose of Trip Reimbursable Amount Item

t0 Ir o vtJ JV,. S ~y!C- .A:'~JUTJ T'f </'-I I\\0/1~ ~ CA-f;Af/;;lZ :r'DLI C.Y , ..._,' .C)~ '.:>.1,0/t.1,, LJ::t-'r<u en_ S.oP. 'EV fH ~-rnID//' 7 ~\/~ -PL:A-vtJ1 AJ'- fr~ '\ .:;z;;> .;71

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I(continue on back) Total This Page IEl'O I For .l\ccounting Use Only I- miles@

Total Reverse Page I·APPROPRIATE RECEIPTS .:_____.. Other

MUST BE ATTACHED GRAND TOTAL 75'(\ I! I !. I Pay

f~ 1~Q"Y\ ·~..

_LJ .·.~~..:.'( '(]'CA;'·Employoo ~Date - ~~/CJ. , (

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D APPROVED

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IACCOUNTNUMBER_


. ·];_,)f~..nl-.J'

•.•• •I '•••~ -,_-,..,~:"'>'"• ,•• • _,,..._ -<•;. ~- "< ·,. ••••• ' •• - .•• - •J',1• ~· -- ,_,_ .• ··- ,,.:; _., •• t •r-~"'0-.-.~•·-- ,.._,.... ..,,•• : );,,__,,·. ·"., •.•,_;.,..•.••.•.~&fr-· "'""" ..*;:;;;;"' ,·- · :..•.....,·~-....-.•..•,...,.._,..'f·-·t ...;;::;.•~:::::·-.1;;., ::re·.~.•.- . ,_,~·..,•· _,,-::;"'·•.-, ... ·"iii Division of ControllerI MONTGOMERY COUNTY PUBLIC SCHOOLS MONTHLY STATEMENT OF MILEAGE ~

Rockville, Maryland 20850 FOR USE OF PRIVATE VEHICLE I•-'"' -· .--. _,.,..,.,_,,,. ___ ...,.............. -·· ., •••• ~ -- ·r. ..••..••••.•.••••.• - ••••••.•••..•.•••,. ••.,.•••, •.••••.•••,. k.,.-.,·a.· ···-'---"··-· ..•...•...._~.,... i\% .·W ""1""""'·._·c...o.e=""'·- __,.zi--.>;r.·.,.- ·Wtrt .-,,.,..,.• ..._._.,,..,,_.,~e~J ,,INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For addition a.Iiniormation, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Base School Location New:0 Yes0 No' ,.. 0

I 0 I 0 I 0 I I I I I IEmployee ID No. . Board of EducationName (Last) (First) (Middle} No. Miles to and from Home and Base Locatiot


Adcress (Street No.) (Streei) (Apt. No.) Job TitleI Board Member --

(City) (Staie} (ZIP Code) Submitted for Month oi:~rMaryland Use one form for each mont .

/

No. of Miles Parking, Tolls, Public Transportation"Date Destination Purpose of Trip Reimbursable Amount ItemI

'1' /£; ~tf-t<Q 0w~iet. -.ii r:o l\llv 2.) .oIY/1~ '~"~~ l\a.\~ M1t111...,,, ,.,;;:::-:;~1,.. _:)5 .nrt/1 JrJ CA- e-:~e: JrZ-D f::-Oupp~o,J 2..2..oq/"2b ~l/E-~ ?k J>fL t-""6 OJ)3 . 22.,,, • lJq/2{,, t.AeU!?<- n;\ f?t,..L -r I rv\.er:s, ":2 ~ .£-

I

(continue on back) Total This Page I JO· 0

~

ForAccounting Use Onlymiles@Total Reverse Page I

'APPROPRIATE RECEIPTS Otheriv/UST BE ATTACHED GRAND TOTAL //0. o I Pay

f~~P·Au_ 1£~_)_3 -' irc;J""Ci.' Employ"Date '.~w wt3__J__J_

Sigr ;ftUre, Principal/Supervisor Date .,"/?

DAPPROVED d/~~~ ~Jt_j]C/ ~ SignatuBe6unt Manager Date

ACCOUNT NUMBER _


\.) \ ·i·,n .\

··,J ;....... /.

-...._./



MONTGOMERY COUNTY PUBLIC SCHOOLS• Rockville, Maryland 20850

MCPSForm 234-21June 2009

~

Card member name Patricia O'NeillSchool/office name B~o;ar;d~o~f~·E~-d~L~lc~a~t~io;n=------------------------=~~------==================

For the period: From June 29, 2013

Work location CESC, Room 123

To July 28, 2013 .USE SEPARATE LOG FOR EACH ACCOUNT

Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be identified.) .(03, 05, etc.)

07/08/2013 07/10/2013 $38.18 Dupars Hamburger Hamlet, Bethesda Lunch meeting with Smondrowski 07/28/2013 504091

re: BCC Cluster and Policy CNE

07117/2013 07/19/2013 $38.93 Dupars Hamburger Ham let, Bethesda Breakfast meeting with Zuckerman 07/28/2013 504091

re: Transition

Total $77.11

CERTIFICATION STATEMENT

I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresentation or omission from this log maybe grounds for cancellation·

ofmj9~!2J2l~t:er. action 21__l_b_l3 ~ ~ 1[0-1Signature,CaraMember Date Signature,Apprw;~/Official ~Date iJ53

fjCorporate PurchasingCardmember Report ,::1:E:~~t:::r&

•' ·./:·; :::.;::;~-:--~::)_.::·::..::·:_.::>:. ·.:.:f} \)Jt

Page 1 of 2



. .· 77.11

.ared For

ATR!CIA O'NEILLJICPSMDTAX 3000123-5

" •...•...~ ••.•1i.,r ••....,~( Closing Date07/28/13

./

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PreviousBalanceS New Charges$ Other Deb~s$ Payments$ Other Credrts$I o.ooll 77.1111 o.oolj::-::=:·····:":.r:L~·8?}J··::·.)...· }T9·9.?:I

For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4.920 .

"0"Cl"e-0"'eoco.•.-r-0

Activity Dare reflectseithernansectionor poslirg date

0.•.0

0


.g Card Number Re{erence Code Arno~nf ~

g 07/10/13 00025317900

07/19/13 D.LJPARSHAMLET. 542929 BETHESDAREF# 000262004 3018975350

MD07/17/13

00026200400

DUPARS HAMLET 542929 BETHESDAREF# 000253179 3018975350

MD07/08/13

38.18

.. 38.93

New Charges/Other Debits 77.11Payments/Other Credits 0.00

Total for PATRICIA O'NEILL


Account N11mh<>r Please enter accountnumber on allcorrespondence.

N0~00

PATRICIA O'NEILL

~

.MCPS MDrAX 3000123-5850 HUNGERFORD RM123ROCKVILLE MD 20850-1718

Check here if address,telephone number, ore-mail address haschanged. Note changes onreverse side.

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Division of Controller 11

MONTGOMERY COUNTY PUBLIC SCHOOLS MONTHLY STATEMENT OF MILEAGE iiFOR USE OF PRIVATE VEHiCLE

Rockville, Maryland 20850"-~- '" ,,,..._,,;' :---L-... ,,,- ,.5 ..."CK~----·-'.,.,,,_.••,.•••••,,••-W<r.·W·.,, ',. __+fr' _ J--· ,..,__ -~. IO.r-· ••• ,_, •••,_ - •• '" •• -- '' .,..,"_ ____ ........ -= ... ~-

·INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional iniormation, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Base Schoo! Location New:C Yes C2f No

Employee ID No. I 0 I 0 I 0 I 0 I I I I I J Board of Education

Name (Last) (First) (Middle) No. Miles to and from Home and Base l.ocatiot


Address (Street No.) (Street) (Apt No.) Job Title

Board Member

(City) (Staie) (ZIP Code) Submitted for Month or:c_J ' IyMaryland Use one form for each mo'ri-r/

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MONTHLY STATEMENT OF fVl!LEAG~_, l ;".FOR USE OF PRIVATEVEHiCLE ri ·

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INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month. lSupervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms by 1

the sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Division of ControlierMONTGOMERY COUNTY PUBUC SCHOOLS


l.

Employee ID No. I 0 I 0 I 0 I 0 IName (Last)

O'Neill


(City)

!(First)

Patricia (Apt. No.)

(State)

Maryland(ZIP Code)

Base School Location New: 0 Yes 0 No

Board of Education

No. Miles to and from Home and Base Locatioi

22.0

Job Title

Board Member

Submitted for Month of: \ -_J q,_J Ii/ t:::

Use one form for each month

Date I Destination Purpose of Trip No. of MilesReimbursable

Parking, Tolls, Public Transportation*

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for Accounting Use Only_____ miles @ _

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IVlCPS Form 220-2, Rev. 8/07

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MONTGOMERY COUNTY PUBLIC SCHOOLS MONTHLY STATEMENT OF MILEAGE i

Rockville, Maryland 20850FOR USE OF PRIVATE VEHlCLE

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INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third oi the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops In date order.

Base School Location New:0 Yes (2]No

Employee ID No. I 0 I 0 I 0 I 0 I I l ! : I Board of Education

Name (Last) (i:'irst) (Middle) ·No. Miles to and from Home and Base Locatiot


Address (Street No.) (Street) (Apt. No.) Job Title

Board Member

(City) (State) (ZIP Code) Submittedfor Month of: MA~Maryland Use one form for each month

No. of Miles Parking, Tolls, Public Transportation"Date Destination Purpose of Trip Reimbursable Amount liem

A I

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Division of Controller MONTHLY STATEMENT OF MILEAGEr.~-);.,·...

MONTGOMERY COUNTY PUBUC SCHOOLS /.}d'Rockvi!le, Maryland 20850 FOR USE OF PRIVATE VEHICLE .-/,

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INSTRUCTIONS: This iorm should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Base School Location New:D Yes (2f No

Employee ID No. I 0 I 0 I 0 I 0 I I I I I I Board of Education

Name (Last) (First) (Middle) No. Miles to and from Home and Bas·el.ocatior


Address (Street No.) (Street) (Apt. No.) Job Title

Board Member

(City} (State) (ZIP Code) Submittedfor Month of: f/f J1._, ( L__Maryland Use one form for each month

No. of Miles Parking, Tolls, Public Transportation"Date Destination Purpose of Trip Reimbursable Amount Item

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ACCOUNTNUMBER .

MCPS Form 220-2, Rav. 8/07

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Division of Controller - 1 ,- .-- F Ml r:MONTGOMERY COUNTY PUBLIC SCHOOLS M~N 1H_Y STAI EMcN~ 01 r=· ••~E1:_uE

Rockville, Maryland 20850 t-OR USE OF PRIVAI E l/clii~Li::••• - • • ·-- '· '- ~, •••,.~.•~•• '•¥ •••• -••~._._...... • ••••• - """.__..,.., _, •••••••••• ·- ••••• ....~.,....,. _,., • '"~ __ , ••....-. " •••••••_••,,.. •• -- ,__ - •• , ,._

INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

BaseSchoolLocation New:0 Yes\Zl No

EmployeeID No. I O I O j O I O I I I _I~~ Board of Education

Name (Last) (First) (Middle) No. Miles to and from Homeand Base l.ocatior


Address (StreetNo.) (Street) (Apt.No.) JobTitle

1 Board Member

(City) (Stat~) (ZIP Code) Submittedfor Monthof: ~C.lJ;Mai yland Use one form for each month

I. . . . No.·of Miles Parking,Tolls, PublicTransportation~

Date Destination Purpose orTnp R . .__ bl_ _ e1muursa e Amount Item

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ACCOUNTNUMBER------------


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\ :\ \ \



MONTGOMERY COUNTY PUBLIC SCHOOLS• Rockville, Maryland 20850~


Card member name Patricia O'Neill

School/office name ~B~o~a~rd~o~f~Eid~uc~a;t~io~n~===-============:-;:::::~~~~~~~=~~~~~~~~~~~~~~~~~~~=For the period: Fro~ February 28, 2013 Work location CESC, Room 123

To March 30, 2013 USESEPARATE LOG FOR EACH ACCOUNT

Date Ordered Date Delivered Total Amount. Supplier Name . Supplies/Services (required) Statement Date Account($) (Student or other=-rnust be identified.) (03, 05, etc.)

0311912013 03/19/2013 $56.04 Hard Times Cafe, Rockville Dinner meeting prior to cluster meeting 03/30/2013 504091

w! O'Neill, Brandman, Smondrowski

'

Total $56.04


I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. Allpurchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresentation o omission from this log maybe grounds for cancellationof my purchase card privilege and/or disciplinary action.

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-reparedForPATRICIA O'NEILLMCPS MDTAX 3000123-5

ClosingDate03/30/13

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For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4920.

"'~ Activity Date reflectseither transactionor postingdate

ReterenceCode Amount$g Card Numberg 03119/13 HARD TIMES CAFE ROCK ROCKVILLE

REF# 82 301-294-9720MD

03/19/138200000JOOO 56.04

Total for PATRICIA O'NEILL - New Charges/Other DebitsPayments/Other Credits

56.040.00


Please enter accountnumber on allcorrespondence.

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PATRICIA O'NEILLMCPS MDTAX 3000123-5850 HUNGERFORD RM123ROCKVILLE MD 20850-1718

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Division of ControllerMONTGOMERY COUNTY PUBLIC SCHOOLS


MONTHLY STATEMENT OF M!LEAGEFOR USE OF PRIVATE VEHJCLE

I I I I I(First) (Middle)

Patricia

(Apt. No.)

(State)Maryland

<ZIPCode)

INSTRUCTIONS: This form should be submitted to your immediate supervisor by the third of the month for the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Employee ID No. I 0 I 0 I 0 I 0 IName (Last)

O'Neill


(City)

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Date DestinationN?. of' Miles I Parking, Tolls, Public Transportation·Reimbursable Amount I Item

Purpose of Trip

I fo I

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.<2.0 I--

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Total Reverse Page

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Base School Location New:0 Yes i;zi NoBoard of Education

No. Miles to and from Home and Base Locatio

22.0

Job Title

Board Member

Submitted for Month of: r-~b,

ii

~PROVED &~/-Signatule,Accoffnt Manager

ACCOUNT NUMBER _


Use one form for each month

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!.

~_l_J~· Date

'/J_JJ_/)Date-

,,. - .• -·- .·-· ·--· ....- ..•..,...:_ ' .,_.- ...,.....,.,__ ,....,. . '• . ~-.~ ·- ~ •. ~ ·~ '•<;.-<.•.-··•.__.__ ., ............•._ --- .. - - ~-.. ,.

Division of ControllerMONTHLY STATEMENT OF MILEAGEMONTGOMERY COUNTY PUBLIC SCHOOLS

Rockville, Maryland 20850 FOR USE OF PRIVATE VEHICLE

• q-•••• -... -· ···••··__,, ·- .., ... ~.· .,.... . .., -· -- --- .•. .,., .,..•. .. ·- ~·- -INSTRUCTIONS: This torrn should be submitted to your immediate supervisor by the third of the month tor the preceding month.Supervisors will forward immediately to the appropriate account manager; the Division of Controller should receive forms bythe sixth of the month. (For additional information, see MCPS Regulation DIE-RA: Local Travel.) List all official stops in date order.

Base School Location New:0 Y~s\2lNo

EmployeeID No. I 0 I 0 I 0 I 0 I I I I I I Board of Education

Name (Last) (First) (Middle) No. Miles to and from Horne and Base LocatiorO'Neill Patricia 22.0

Address (Street No.} (Street) (Apt. No.) Job Title

Board Member

(City) (State) (ZIP Code) Submitted for Month o~ 2D I 3Maryland Use one form for each month

No. of Miles Parking, Tolls, Public Transportation·Date Destination Purpose of Trip Reimbursable Amount Item

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ACCOUNT NUMBE~






Card member name Patricia O'NeiJISchool/officename iB~o:a~rd~~of~E~d~u~ca~t~io~n~-------------------------------------============

Forthe period: From December 29, 2012

Worklocation CESC. Room 123

To January 28, 20 l3 USESEPARATE LOG FOR EACH ACCOUNT


01/23/2013 01/24/2013 $52.20 Clydes Tower Oaks,Rockville Lunch meeting with Boardmember 01/28/2012 504091

Rebecca Smondrowski

Total $52.20


I certifythat; to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. Allpurchases were made insupport of school programs as outlined in the PurchaseCard Guide. I understand that any material misrepresent omissionfrom this log maybe grounds for cancellationof L-~ard privilege0d/or disciplinaryaction. ~ .

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CorpoR"aite PurchasingCardmember Report

Prepared For

PATRICIA O'NEILLMCPS MDTAX 3000123-5

Account Number Closing Date01/28/13 Page 1of2

PreviousBalance$ New Cha;-ges$

0.0011 52.201[Other Debits $ Payments$ Other Credos$

~l'·.:.::-::':·."'::.:-.=.=.:::=:_: ..::J.'.~ia~ll':·=.. :.-..:::.-:1=:·,::::::=:_.::,'_-:::~i~~i- 52.20'' -

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For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4920.Activity Date reflects either transaction or posting dale

y=;stG:=-9.~..,ec~e Amount SCard Numbe·01/24/13 CLYDES TOWER OAKS LG ROCKVILLE

REF# 156 301-294-0200MD

01/23/13156COOOOOOO 52.20

- Total-for PATR•CIA-07NEILl:--- - - - - · - - - - - New Char§es!Gt-her·Debits - - - - ·Payments/Other Credits

. - ·52.20- - .O.DO


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~


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01/23/2013 - Patricia O'Neill - Lunch meetingwith Rebecca Smondrowski

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0156Server: VICTORIA Y01/23/13 14:00, ~

Rec: 111T: 345 Term: 10

.301--294-0200WWW.CLYDES.COM

d156 Table345 #Party2VICTORIA Y SvrCk: 7 1: 16p 01/23/13RESTAUl~l\NT ·

,._,YOES TOWER OAKS l! 11.1:JE..PkES~RVE PARKWAYROCKVILLE, MD 20859('3011294-0200

r : ! . 1f\N1 Jl:

CARD I :i-,E ACCOUNT NUMBER

2 WATER 0.001 CLUB SODA 2.851 ICED TEA 3,001 BACON CHZBURGER, mediLITT 11 .951 JUMBO CRAB S~ND 16.95.1 HOT TEA 3.501 DECAF COFFEE 3.50

AMERlUiN EXPRESName·: PO NEILL

·""TRANSACTION APPROVED1DRIZATION #: 504317~rence: 0123010000156IS TYPE: Credit Card SALE

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MCPS Form 234-llJune 2009

Card member name Patricia O'Neill

School/office name !B~o~a~rd~off~E~d~u~c,~1t~·.io~·11~--------~--------------==-=---=------------===============For the period: From September 29, 2012

Work location CESC Room 123

To October 28, 2012 USE SEPARATE LOG FOR EACH ACCOUNT

Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other=-rnust be identified.) (03, 05, etc.)

10/04/2012 l 0/05/2012 $23.02 Clarion Fontainbleau Hotel Breakfast while attending MABE l 0/28/2012 504091

Annual Conference - PO, NK

10/03/2012 I0/08/2012 $I5t.53 Clarion Fontainbleau Hotel Lodging, MABE Annual Conference l 0/28/2012 504091

I0/03/2012 -10/07 /20 12'

Total $17f55


I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresentation or omission from this log maybe grounds for cancellationof my urchase card privilege

1d/or disciplinary action. . . . <# .

~ · lL1 2 7;-13:-- 1 Q ,, O JL._SL L7--r~1 _IDDate 5ignatuk, APPfOvingOfficial Date

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,d,ss~ -Jil~~llll~Corporate Purchasing

Cardmember Report

PreparedForPATRICIA O'NEILLMCPS MDTAX 3000123-5

Closing Daie10/28/12 Page 1of2

000a"'coa""



PreviousBalance$ NewCharges$ Other Debns$ Payments$ OtherCredits $

I 56.78ll 174.55ll 0.0011·:;:::,:.=\''::.:t"::'=.;:·~?::'?~llr.:::\,::,:,.,.~.,901 .. . 174.55' -· •;_ •. •• I ~

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For your recordsonly - do not pay.-c0-c"'"'-e-0a:~..•.0

Forassistanceor questionsabout your account, contact us at www.americanexpress.com/checkyourbill orca!! Customer Service at 1-BOQ-4~2-4Q2Q.

Activity Date reflectseithertransactionor postingdale

HeierenceCede Amount$g Card Numbe · ·

g :'::1wfi~!1?t==:::::~qft~9RA1~:ijgMf1W~~Mti*fA§JY@ttn:::::=~;9gi;gJ;::t;::-=:::::;: :: :::•./ :::::::: ··.... ··.. : ..10/05/12 CLARION RESORT FONTA OCEAN CITY MD

-REF# 0·41Q!'i24353-5 i-O/-Q4/-1-2

·.:······ ., ;; HJM?.~Zg::23.02

10/08/12 CLARION RESORT HOTEL OCEAN CITY MDFOL# 649888 LODGING 10/08/12ARRIVAL DATE DEPARTURE DATEt0/03/12 10/07/12 00ROOMRATE $145.00ROG NUMBER 649888

151.53

Total for PATRICIAO'NEILL New Charges/Other DebitsPayments/Other Credits

174..55-56.78


/\.......,,...,,..,, ~l11n">l···••:u· Please enter accountnumber on allcorrespondence.

N0e-00

PATRICIA O'NEILLMCPS MDTAX 3000123-5850 HUNGERFORD RM123ROCKVILLE MD~

,.:. ."'....er

a20850-1718

C5-c"'"'.,.a"'"'•..."'0

Check here ii address,telephone number, ore-mail address haschanged. Note changes 01reverse side.

l11l1ll l111l 11l11l. I, I l111111Ill111l 111 lll.1 l11l1 l1l l11111l l1l

DClcc

10/04/2012 - Breakfast meeting while attendingMA.BE's Annual Conference, O'Neill, Senator King

~1c: ·ion Fonte inhleau Hotelh11·izons Restaurant

1201 ky.m-~-- -----·-----·----·-· ·-·-··----~---

CHK 177 46 GST 2OCT04'12 8:0lAM

Dining

1 Or:1e 1et-Chz s.001 add mushrooms 0.851 add ~1eppers 1 .001 W2f f·e w/ tup 7.00

Foo j 17 . 850.5K City Tax 0.096.LI~ !='""~T-·T:

FJl ·1 ·3ervice Revenue CenterCHE>. 177:JSTCiiK [[J: 463ERvrn: 1201 Ry.an).~TE: OCT04' 12 8 :'.3BAM:AR) -:y.Jf:: ~erican Express1CCT 1.•EXP D/!.T:::AUT'1 CO:)[:

XX/XX542568PO NEILL

0 Je--k-P-l((A-~SUBTOTA_: 19.02

GratuH;: _ /_1'·-·---.!:::l'-1 Gl[l_

Tot3J : 2-_~_!_Q~

x.·_f~_I aJree to pay the above amounf1. cordance with card holdera[;, .aent.

f\.)~~~ KI N&s-r=pA--r D c [)D~ L'---

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to/03/2012 - 10/07/2012 - Hotel stay while attendingMABE's Annual Conference

Fontainebleau Hotel10100 Coastal HighwayOcean City, MD 21842United States410-524-3535 Fax: 410-524-3834

Patricia O'NeillMontgomery Co Board Of Ed850 Hungerford DriveRoom 123Rockville, MD 20850United StatesBElOOl - Mabe

Page Number : 1Guest Number: 649888Folio ID ANo. Of Guest: 1Room Number : 1211Club Account:.lill. Account

Arrive Date: 10-03-12Depart Date: 10-07-12

Copy Tax Invoice

Fontainebleau Hotel 10-07-12 09:01 GERRIH

Date Reference Description Charges Credits

10-03-12 DEPOSIT Deposit Applied -151.5310-03-12 RT1211 Room 145.00

Exch Rate: 010-03-12 RT1211 4.5~ Occupancy Tax 6.5310-04-12 RT1211 Room 145.00

Exch Rate: 010-04-12 RT1211 4.5~ Occupancy Tax 6.5310-07-12 AX American Express -151.53

***For Authorization Purpose Only***

Date Code Authorized10-03-12 560338 602.47

** Total 303.06 -303.06

*** Balance -0.00

Signature~~~~~~~~~~~~~~~~~~~~~-I agree to remain personally liable for the payment of this account if thecorporation or other third party billed fails to pay part or all of thesecharges.



MONTGOMERY COUNTY PUBLICSCHOOLS• Rockville, Maryland 20850~


Card member name Patricia O'NeillSchool/office name ~B~o:a~rd~of~·~E:d:u~c.a~t~io:n~-------~-----------------------------============

For the period: From August 29, 2012


To September 28, 2012 USE SEPARATE LOG FOR EACH ACCOUNT


/09/27/20120I/ 09/28/2012 $56.78 Mama Lucia, Rockville Lunch mtg. to discuss legislation with 09/28/2012 504091

Delegate Barkley, O'Neill and Docca

I

'

- ··-

Total $56.78


I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. Allpurchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresent~mission from this log maybe grounds for cancellationof;;;l<P""h'.'""d pc;,;i~ and/or disciplinaryaction . ·~ . . .

,Jczr:~r;;)!S>Le ;~ lL1_2_1b:-- · ,,,Q....o JL. IL u.._/'1--t...L+-Signature, CardMembi"FW- Date · SigmtLJ:WfrD\lmg dffiC;a/ Date -

,, < (Sign~up.For~<hdineStatements,t Corporate Purchasing

A Cardmember Report:. . . . .' . .

·www :ameriGane)(pi;e8$,9.o0icheckyowrbill

.eparedForPATRICIA O'NEILLMCPS MDT AX 3000i 23-5

Account Number ClosingDale09/28/i 2 Page 1 of 2

0000

"'CXl0N

PreviousBalance$ NewCharges$ OtherDebits$ Payments$ OtherCredils$

42.9911 56.7811 0.0011 42:9911 · 0:001 . 56.78' ' - . ·~



0

"""0

0

For your records only - do not pay.""0"""'"',,.0a;coCXl""~0

For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4920.

·Activity Datereflectseithertransactionor postingdate

Refererce Cede Amount S5 Card Numbe1a

g ~~9i07/i2===-=r=:caf:irqfiA'f~FR'EM}'f:t!iif1ci= RE;e;;Erve:o : ·· ··:..M/or .··· · ·= · · - = : = ~-· · -42,99 ·09/28112 MAMA LUCIA OF FALLS ROCKVILLE MD 85431382272 56.78

- - -Rff# -B5i43~3-8-2-2-7-2-301-468-7084 09/27 /1-2

Total for PATRICIA O'NEILL New Charges/Other DebitsPayments/other. Credits

56.78-42.99


Accour.1 • •• ·~1...~. Please enter accountnumber on allcorrespondence.

N0

00 ~\ll

~

PATRICIA O~NEILLMCPS MDTAX 3000123-5850 HUNGERFORD RM123ROCKVILLE MD 20850-1718"'IX)

"'0

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Mamrna Lucia14s:· ~ Shady Gro\'e RdPockv i11e, MD 2op•,f·

(30"1) 762-063,

150 PATEL

Tb l 406/1 Chk 23~Sep27'12 12:0t.

2 Soft Drink @ 2.251 Gamb Milano

No1 Po11o Masra rpBaked Z" ig

Sau

SuutotalTax

;?:37PM Tota1

46.002.76

48.76

Tax1 Col1

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Online Order tno Now Available

4.5015.00

13.0010.503.00

2. 76

09/27,_,°20I)~-l,. .D ct11c1z111.e/egfJte 13 eeting to d

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Mamrna Luc ·1a14921 J Shady Grove RdRockville, MD 20850

(301) 762-0635Date: Sep27'12 12:40PMCard Type: Amex.Acct #:Cci'rd Entry:Trans Type:Auth Code:Check:Table:Server:

::iVHPEDPURCHASE523701239406/1150 PATEL

ubtota l: 4B.76

ratu: tv: CJ o D·---------<l~.....·---------~Tota 1: 5-.__ ~-L~2/12d; YL.c.Lri1~ ,,/1s-f9~~ _j-~~~~

I agree to pay above totalacco rciing to my ca rd issueragreement.

* * * * Guest Copy * * * *c~&~W-f..Ju'"t~ ~~m- D'JU2J.Ll-



MONTGOMERYCOUNTYPUBLICSCHOOLS• Rockville,Maryland 20850


~

Card member name Patricia O'NeillSchool/office name is~o~a~rd~o~f~E~d~u~c~a~ti~o~n------------------------:--------------===============

For the period: From August I,2012


To August 28, 2012 USE SEPARATE LOG FOR EACH ACCOUNT

Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account

- ($) (Student or other-must be identified.) (03, 05, etc.)/

08/02/2012 08/03/2012 $42.99 Gordon Biersch, Rockville Lunch mtg. w/Councilmernber Ervin 08/28/2012 504091

'

Total $42.99


I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school programs as outlined in the Purchase Card Guide. I understand that any material misrepresentation or omission from this log maybe grounds for cancellationof mv purchase card privil.ege and/or disciplinary action.

~t)_~J_Q__ -/_/_ ~"~'2 ~.JJ - 9(l-i (f 7; /_·Date~orovino Official Date

{

,:.!:;5••~

l:f1.~Corporate PurchasingCardmember Report

''f~lt~lt~'~'~~711;:J.:www;ameri¢anexpr~.c;;qijtf(ih~ckyo1;1rqilff

·.. ; =··.· . : : ::.:.::->=·::::.::.. '' :·(.;;;~~~~PreparedForPATRICIA O'NEILL .MCPS MDTAX 3000123-5

Account Number Closing Dais

08/28/12 Page 1 of 2

0000l{)

~"'

PreviousBalance$ New Charges$ Other Debns$ Paymenls$ Other Credos$

I o.oo II 42.9911 0.0011:<::,>:.:. :.,,:,::-:; ;P::?:?ll.::::::: <, ::::: ..:;f_:.~21: 42.99' . - ~

BalanceDue $ Do Not Pay

For important informationregardingyour accountrefer to page2.

0

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a0

For your records only - do not pay.<(0<(~;;:0

"'coss»"'0

For assistance or questions about yo_uraccount, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4920.

Activity Dale reflectseither transactionor postingdale

Refererce Code Amounfsg Card Numberg 08/03/12 GB-ROCKVILLE 513 005 ROCKVILLE

REF# 146 423-424-2000- - - - - - - - .EOOD/ BEVERAGE I

ROC NUMBER 146

MD08/02/12

14600000000 42.99

Total for PATRICIA O'NEILL New Charges/OtherDebits 42.99Payments/OtherCredits 0.00


'----~ "··-~-- Pleaseenter accountnumberon allcorrespondence.

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l11l 1tl1,, .!,, I 11I1l1It111111l!l,,1l111 I IIul11 l1l1ll,,,, ,I I, I Check here'it address,telephonenumber, ore-mail addresshaschanged.Notechangesonreverseside.

D.o00

0810212012 - O'Neill lunch meeting withCouncilmember Valerie Ervin

0146Server: CLARA H Rec: 6008/02/12 13:49, Swiped T: 55 Term: 7

GORDON BIERSCH-ROCKVILLE200 E. MIDDLE LNUNIT A(301)340-71~59MERCHANT #:

CARD TYPE ACCOUNT NI IMRrnt:MERICAN EXPRESName: PO NEILL00 rnANSACTION APPROVED

HORIZATION #: 529052;rence: 0802010000146

·~~~sTYPE: Credit Card SALE

ECK:

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CAROHOLDER \HLL PAY CARD ISSUER ABOVEAMOUNT PURSUANT TO Cft.RDHDLDER AGREEME~ffASK ;~BOUT OUR BANQUET ROOMdupl lcate copy -> customer

Documents

2012-14 O'Neill Expense Reports