HomeMy WebLinkAbout255607 02/26/16 i°r,C5H'�s
CITY OF CARMEL, INDIANA VENDOR: 366341
�.;, I• ONE CIVIC SQUARE BRADLEY HOLSTEN CHECK AMOUNT: $ 30.66
?�; CARMEL, INDIANA 46032 C/o ESE CHECK NUMBER: 255607
°j��Toa`�' CHECK DATE: 02/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 022316 30.66 TRAVEL FEES & EXPENSE
)
/
/
/
Voucher No. Warrant No.
___________
Allowed 20
Holsten, Bradley
208Cali Court
Indianapolis, IN 48280
ONACCOUNT OFAPPROPRIATION FOR �
/
i08 -ESE /
'
------ | Board Members
PO#or INVOICE NO. ACCT WTITLE AMOUNT
Dept#
1081-99 Reimb 4343000 $ 15.00 | hereby certify that the attached invoim(o). or
1081-11 Reimb 4343000 15.66 bi|/(o) ia(am)true and correct and that the
materials orservices itemized thereon for
which charge iomade were ordered and
|
received except
/
February 18,
`
�
| 2016
Signature
$ 30.66 Accounts Payable Coordinator
Cost distribution ledger classification if Title
�
claim paid motor vehicle highway fund
{
Carmel • Clay
Parks&Recreation .
Employee Expense Reimbursement Request
Date.of Fund Account Account'- .
Receipt Vendor listed on receipt # Line#- Budget Description Amount Purpose of Expense
1/28/2016 Bankers Life Fieldhouse 1081-99 Travel Fees'&Expenses $ 15.00 Parking
e C�
0.00
All receipts should e attached.In the same order as listed above.
No sales tax will be:reimbursed. TOTAL: $15.00
Employee Name(print) Bradley Holsten
Check Address 09 Cali Court
payable to: City, St,Zip Ind' na olis, IN 46280
Signature* Approved:by:
Date: 2/4/2016 Date:
Business Services Division,Revised 7-7-08.
FILE: Shared\Ndministrative\Forms\Staff Forms\Employee Exp Reimb Request
$ -ECE1 V SL'¢eD
FEB 1 -8 '_016
ICY-
Fawcatuo BY BrAYE BOARD OF AOCODNN - GINERAL FORM NO.101(1096)
;��
MILEAGE ' �ZAV2L
r 1 — CbL J �I�lf t ro
CA 2P1EL Ct a AL _ - 1
Y T A<;1CS � '�EGA—LF r�)6'jON'ACCOUNT OF APPROPRIATION NO: FOR
DNW) L
(OIk7 .BOARD.DLFAR'nnrir oB O 5
SPEEDOMETER
DATE FROM TO READINGIFROM
11�1i �j2 ESE AUTO MILEb1ARG
NATURE OF BUSINESS �E
•
POINT POINT START FINISH TRAVELED
7 L66559'—p=42— o o
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance batween points cannot be determined by fixed mileage or official highway map.
Pursuant to the p visions and penalties of Chapter 155,Acts 1853,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due, ter iag ust credits
end that no part o e same has been paid.
V _
I io
(ill` 713Y:
s ! 82016
" Event Parkingg
Bankers Life Fieldhouse
125 S. Pennsylvania St
Indlenapotis,IN 46204
317-686-0486
i
Damson Parking Inc. 4
Transaction: 1005380
Attendant: Trevor D.
Lot: Maryland Street Garage
Amount: $15.00
Time: Jan 28,2016,6:03 PM
Type: Cash
$15.00
Thank You for parking with usl
1
t
i
Carmel • Clay
Parks&Recreation
E ployee Expense Reimbursement Reque$� t
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description I Amount Purpose of Expense
1/28/2016 Bankers Life Fieldhouse 1081-99 B@ Travel Fees&Expenses $ 15.00 Parkin
I
I `
I)
i
f 0.00
All receipts should a attached in the same order as lisfea above.
No sales tax will be reimbursed. TOTAL: $15.00
Employee Name(print) Bradley Holsten
Check Address 1 09 Cali Court j
payable to: City, St,Zip Ind na olis, IN 46280
Signature• _ Approved by:
Date: 2/4/2016 Date:
Business Services Division,Revised 7-7-08.
FILE: SharedWdministrative\Forms\Staff Forrns\Employee Exp Reimb Request
i
EI V t+•
FEB 18 c�16
BY:
I � �i