233826 06/18/14 CITY OF CARMEL, INDIANA VENDOR: 368328
® ONE CIVIC SQUARE MEGAN O'MALLEY CHECK AMOUNT: $*****...60.00*
CARMEL, INDIANA 46032 5183 WARBLER WAY SOUTH CHECK NUMBER: 233826
CARMEL IN 46033 CHECK DATE: 06/18/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 5023990 60.00 OTHER EXPENSES
Carmel Art Gala Artist Payments
Alex Hiller 1397 N Claridge Way Carmel IN 46032 $ 20.00
Daniel Rayl 13994 Springmill Ponds Circle Carmel IN 46032 $ 32.50
Aaron Ibey 11720 Westwood drive Carmel IN 46033 $ 22.50
Veeanna Edwards 1107 Laurelwood dr Carmel IN 46032 $ 25.00
Megan O'Malley 5183 warbler way south Carmel IN 46033 $ 60.00
Stuart Summerville 1449 East Lynn Drive Indianap IN 46202 $ 37.50
Alex Mikev 11209 Basswood Court Carmel IN 46032 $ 62.50
Gretchen Nihil 12131 pebblepointe pass Carmel IN 46033 $ 10.00
Vjatscheslav Kharitonenkov 3812 Verdure Lane Zionsvillf IN 46077 $ 40.00
Luke Meyers 331 west main street Carmel IN 46032 $ 25.00
Total Amount Due $ 335.00
ec
Non-reimbursement Expense Receipt
Non-reimbursement expenses are transactions that are charged directly to a CMYC account.
After completing this form, please submit it to the Council Clerk-Treasurer.
Expender: Jack Langston
Vendor(location of purchase): Multiple Carmel Art Gala Artists
Date: 5/2/2014
Event/Activity (if applicable): Carmel Art Gala
Expense Account(see list of accounts): 5500
Additional Description: Please see the attached sheet for individual expenses (50%
Commission)
Expense Amount (do not include Sales Tax): $335.00
Account Charged: =CarmnefOther
I verify to the best of my knowledge that this information is correct, and this purchase was
on beh CMYC and no or personal use or gain.
o� 0 2d ly
pend r S n tore Date
Please submit this form to Clerk—Treasurer along with the purchase receipt.
Appendix 15 —Page 1
CNIYcm
For use by Clerk—Treasurer
Received and approved with correct purchase receipt by Clerk—Treasurer:
Signaturea� Ccnem � Date
For use by Council President, VPE, or VPE
Expense has been approved by:
Signature. a.,- Date: position:
00
Appendix 15—Page 2
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))
05/05/14 Receipt List $60.00
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
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Megan O'Malley
IN SUM OF $
5183 Warbler Way South
Carmel, IN 46033
$60.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
854 Receipt List $60.00 1 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
Monday, June 16, 2014
Director, Community Relations/Economi Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund