HomeMy WebLinkAbout233648 06/12/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 065950
ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: $*******483.00*
CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK NUMBER: 233648
CARMEL IN 46033-9501 CHECK DATE: 06/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 483.00 SBOA SCHOOL
II
L
CA
CITY OF CARMEL Expense Report (required for all travel expenses)
No�aNp EXHIBIT A
EMPLOYEE NAME: l�L DEPARTURE DATE: f TIME: AM/ M
DEPARTMENT: RETURN DATE: TIME: AM/. M
REASON FOR TRAVEL: fic /��D DESTINATION CITY:
EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
$0.00
C-0 $0.00
$0.00
$0.00
$0.00
7c� $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 $0.00 $0.00' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
DIRECTOR'S STATEMENT: I hereb irm4hat'all es I' ted conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date: t _
r
City of Carmel Form#ER06 Revision Date 6/12/2014 Page 1
WEST BADEN SPRINGS
H O T E L
Name: DIANA CORDRAY Arrival Date: 06/09/2014 Cl Clerk VHAAG
Address: 11843 STONEY BAY CIRCLE Departure Date: 06/11/2014 CO Clerk
CARMEL IN 46033 Group Code: 06141NL
Roam.#; WB 4551 Resv 417492688936 Page 1 of 1
Dale Reference- Des:criptian Charges. Credits
06/09/2014 417989000493 ROOM CHARGE WB 4551 179.00
TAX1 12.53
TAX2 7.1.6
06/09/2014 417983378372 BALLARD'S LOUNGE 4.40
06/10/2014 417999000506 ROOM CHARGE WB 45519.00
TAX 1 12.53
TAX2 7.16
06/11/2014 418003394282 WEST BADEN ROOM CHARGE 39.38
ROOM IS TAX EXEMPT VH
Total Due 382.40
1 agree to remain personally liable for the payment of this account if the corporation or other third party
fails to pay part or all of these charges. I also agree that all charges contained in this account are correct
and any disputes or requests for copies of charges must be made within five (5) days after my departure.
If you are using a credit card, the hold may last up to 3 business days past your check-out date. If you
are using a debit card, the hold on funds may last from 7-10 business days after your check-out date.
Guest Signature:
West Baden Springs Hotel 8538 West Baden Avenue West Baden, IN 47469
888.936.9360 frenchlick.com
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JUNE 8 - 1212014 1 FRENCH LICK
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.
P yee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
- A ALLOWED 20
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
oEPePr.# I hereby certify that the attached invoice(s),
or 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
20
?Sinat r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund