HomeMy WebLinkAbout241741 02/03/15 CITY OF CARMEL, INDIANA VENDOR: 359065
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® ONE CIVIC SQUARE BOB HIGGINS CHECK AMOUNT: $********95.00*
4. a4 CARMEL, INDIANA 46032 1895 WEST 211TH CHECK NUMBER: 241741
'M,iTtiN�o` SHERIDAN IN 46069 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343002 REIMB 95.00 EXTERNAL TRAINING TRA
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CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
EMPLOYEE NAME: �a e/ DEPARTURE DATE: ��,,,, �� TIME: �DO (Aq/PM
DEPARTMENT: Q0,-? ['9ra �'� RETURN DATE: �r,Y, a� TIME: L(;oo AM/ ,M
REASON FOR TRAVEL: �( c�Cc. ,, �� �� _ DESTINATION CITY:
EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
f
Transportation Gas/Tolls/ Lodging Meals
Date Air-fare Car Rental Other Parking g g Misc.
Breakfast Lunch Dinner Snacks Per Diem
59
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DIRECTOR'S STATE I hereby affir that all expenses listed conform to the City's travel policy andare within my department's appropriated budget.IL
gDirector Si nature: Date:
City of Carmel Form#ER06 Revision Date'10/17/2006 Page 1
Prescribed by Slate Board of Accounts General Form No,101 (1955)
MILEAGE CLAIM
TO DR.
(Governments nit)
On Account of Appropriation No. for
(Office,Board,Department or Institution) �
DATE FROM TO
ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @
20 /.f Point Point Start Finish TRAVELED PER MILE
e m« 0. .2 -d'w wt- 1 lS 065- °r
,a ex
to s r ro
Auto License No. TOTALS �—
* SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. I,
Pursuant to the provisions and penalties of Chapter 155,Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just credits, and that"no part of the same has been paid.
Date vtS � 'J
Claim No. Warrant No, I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as requi
by law;
That it is based upon statutory author
That it is apparently Correct
� f �incorrect
On Account of Appropriation No. for
Disbursing Officer
� I
ob
Allowed 20
-
Cr
j in the sum of$ o �.
0
((DD
oN Q
(Board or Commission)
FILED
o
m
(Official Title) ,
O
VOUCHER NO. WARRANT NO.
ALLOWED 20
Bob Higgins
IN SUM OF$
$95.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I B Higgins I 43-430.02 I $95.00 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
Wednesday, January 28, 2015
Director, Broo shi olf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
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))
01/26/15 B Higgins Expenses for Expo $95.00
I
I 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