241394 01/22/15 Oi"
CITY OF CARMEL, INDIANA VENDOR: 364842
ONE CIVIC SQUARE KATHLEEN VASIL CHECK AMOUNT: $ ..."'116.30`
CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK NUMBER: 241394
CARMEL IN 46033 CHECK DATE: 01/22/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 BANQ TIP 116.30 FOOD & BEVERAGES
CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
EMPLOYEE NAME: 1� ,� (� �� DEPARTURE DATE: TIME: AM/PM
DEPARTMENT: �o�d RETURN DATE. TIME: AM/PM
REASON FOR TRAVEL: DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
0
Transportation Gas/Tolls/ Meals ��pp
Lodging
Date
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
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yr
00,
DIRECTOR'S STAT I hereby affir that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
Page 1
City of Carmel Form#ER06 Revision Date'10/17/2006
Invoice
cc
ca
Date: 12/13/2014
®SOF C910 Bill To: Chad Smith
Ad ress:
Brookshire Golf Course Phone:
A
12120 Brookshire Parkway Email:
Carmel, Indiana 46033
brookshiregolf.com
Deposit Received 0
: w,rk c t _F.w i r. .r. .�.:; a:-:.• .�':,•s.w- � '-'.rye"'.':'�r :�;.'•F'Z•;s.3'z.g' �,- e},.. gra-,r;�.
`.. 1E,Y s �aaoff..ra�?'£3escriptori. rirY :': 1 ,' pF�. r: Ct:.a
12/13/2014 Banquet Room Rental for 6 hours $ 300.00
's 12/13/2014 Food and Beverage Tab $ 64.50
12/13/2014 Incidentals $ 100.00
12/13/2014 1 case Nine Vines Moscato $ 117.00
r..
B
Subtotal -$ 581.50
Tax Banquet @9% $ 52.34
Gratuity 20% $ 116:30
C
Amount Due $ 750.14
E.,
Subtract Deposit $ -
Grand Total $ 750.14
Thank you for letting us serve you!
r ,
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
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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))
01/14/15 Banquet Tip Banquet Tip Smith 12-13-14 $116.30
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.
ALLOWED 20
Kathleen Vasil
IN SUM OF $
3779 Simmerman Court
Carmel, IN 46033
$116.30
i
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#t/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 Banquet Tip I 42-390.40 I $116.30 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
Wednesday, J nuary 14, 2015
Ir"L ! `
Director, Brookshire I lub
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund