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HomeMy WebLinkAbout231244 04/08/14 .J 9, ) CITY OF CARMEL, INDIANA VENDOR: 366663 ONE CIVIC SQUARE AMANDA GILLIM CHECK AMOUNT: $Y M MYMi*207.90" CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 231244 CHECK DATE: 04/08/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 207.90 TRAVEL FEES & EXPENSE Carmel 0 Clay "13EC USE K,,P5 Pae-Lcsℜmat oJn CUU�CT " �At ,cam Employee Expense Reimbursement Request CWFEMUCE Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense ;-Z�Z� �3 �►n� ol-is IaO��-�a�-(�wv��t � ' ' 2.30 �Oo��A���d �� fa w All receipts should be attached in the same order as listed above. ©+,3� No sales tax will be reimbursed. TOTAL: Employee Name (print) Address 4iWAI �— Check payable to: City, St, Zip U(0-z' Signa re: Approved by: Date: 2g ) Date: Business Services Division, Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request tMSCOAtO IT STAn ROAAO Or ACCOUNTS 1 CMAAL FOAM NO 10.{19661 MILEAGE CLAIM �n ( r MENSAL 13Ni11 ON ACCOUNT OF APPROPRIATION NO. —_ FOR 6WTCE.WA RD.DW "!Fba"Ox WSrMMON) -•- �•� SFE:IiDO�tE1'El3 D r9 FROM 7p -• � -- AUTO NATURE POINT S:AAT FINISH NATURE OF SUMN}SE TSAMVLLtiD a G• c PER MILE c I A I - -- --— -- Y- 01 l --_-! -_ Vurr ---- __._ _ _.- 3. - 1 Inn U _ ---•--.- Lj .. ._— — -- -z2Z 7-19 C — WOWAtL %2- Z �9T Crni► cmc_ `j --�-�-- _ �_ __—! M7 Co coir r.c ._C2LII .Z A4... 2— T 1-2— ItT - M6'r AUTO LICENSE?10. O I Z TOTALS + SPEEDOMETER READING columns are to be used only when distance between points cannot be determinod by laxed mileage or official highway map. 3•!, j ,s6 Pu:-giant to the provisions and penalties of Chapter ISS,Acts 1953,I hereby ceTtity that the foregoing account is just and correct,that the amount claimed is ly due,after allowing U Just dit- end that no pert off a same has been paid. Date ZIP ,.. ,� _ ., ....n. :at PRFSCRIM BY STATE BOA"OF ACCOUNTS CENFAAL FOAM 110 101 119M MILEAGE CLAIM 1 VERNHtNTAL WI TI ON ACCOUNT OF APPROPRIATION NO. FOR (OF710E.BOARD.DVAATM7Ff OA)Nsr[rUIION) SPEEDOMETER D-TFy c'o FROM V TO � — READING + AUTO 1ULEAGE NATURE OF BUSINESS MILES Edi za p0�• POINT START FINISH TRAVELED PER MILE _ ,y ---- — _.� - "i iN _ t C g. -—�Z--- — -- — "'Z — - _.... T .MCC t 22- 71 a-dk c AL f' c.c — _ u�a�e-•-� u cr.6 ___ - 2 i 3fWT AKLL -- I rid —-- -"i _tl - --_ � 7 2-_ 1_1 Z5L1Aliter�-rn�K�_ y�j _ AUTO LICENSE NO. TOTALS — 1 8 •;r _ �� ` + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. V Pursuant to the provisions and penalties o1 Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct,that the amount c is I ally due,after allowing ) s end that no part of fhe sa a has een aid. _ Date ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 366663 Gillim, Amanda Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 3/19/14 Reimb Mileage 11/12/13 - 2/25/14 $ 167.60 3/19/14 Reimb Travel expenses for conferernce $ 40.30 Total $ 207.90 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 Voucher No. Warrant No. 366663 Gillim, Amanda Allowed 20 In Sum of$ $ 207.90 ON ACCOUNT OF APPROPRIATION FOR 108 - ESE PO#or Board Members Dept# INVOICE NO. ACCT#/TITLE AMOUNT 1081-5 Reimb 4343000 $ 167.60 1 hereby certify that the attached invoice(s), or 1081-99 Reimb 4343000 $ 40.30 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 3-Apr 2014 Signature $ 207.90 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund