HomeMy WebLinkAbout247787 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 362142
ONE CIVIC SQUARE MARK CARTER CHECK AMOUNT: $*`*****`69.35*
CARMEL, INDIANA 46032 888 E 256TH STREET CHECK NUMBER: 247787
SHERIDAN IN 46069 CHECK DATE: 07/28/15
Tpry LA
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 7.00 TRAVEL FEES & EXPENSE
1082 4343000 REIMB 62.35 TRAVEL FEES & EXPENSE
NOW—
Carmel 0 Clay
Parks&Recr'eation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
$7 0
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 7 0 • �._ . ,, ,.�
JUL 15 2015
Employee Name (print) fflor�k
Address ff'' B<`-�–"— -------�!
Check
payable to: City, St, Zip t �w Cc, ,�
Signature Approved ` ^�
Date: 3 T / Date: .
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
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JUL 13 2015
__----------
PRESCRIBED BY STATE BOARD OF ACCOUNTS - GENERAL FORM NO.101 119847
MILEAGE CLAIM
TMJ _
(GOVERNMENTAL UNIT) TO
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPAR-RENT OR INS?=108)
DATE FROM TO i SPEEDOMETER AUTO MILEAGE
,,,
2Q , __ _ READING NATURE OF BUSINESS MILES a •975 4
POINT POINT START FINISH TRAVELED PER MILE
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S _ Yh -a f
S11 ke
_ 3 /►"Mws — — ,rF, rtrry rrLp
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.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally d!!5a ef�r a_1'Iowin'g all-iust-cr d
end that no part of the same has been paid.
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.
Carter, Mark Terms
Invoice ;;t�jl
voice Description
Date umber (or note attached invoice(s)or bill(s)) PO# Amount
7/3/15 eimb Mileage 5/28- 7/3/15 $ 62.35
7/3/15 Reimb Parking for field trip $ 7.00
Total $ 69.35
1 hereby certify that the attached in 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
L
Voucher No. Warrant No.
Carter, Mark Allowed 20
In Sum of$
$ 69.35
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#orBoard Members
Dept#
INVOICE NO. ACCT LE AMOUNT
1082-6 Reimb 4343000 $ 62.35 1 hereby certify that the attached invoice(s), or
1081-11 Reimb 4343000 $ 7.00 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
July 23, 2015
IPAWI��
Signature
$ 69.35 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund