304871 11/03/16 CITY OF CARMEL, INDIANA VENDOR: 364842
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'} ONE CIVIC SQUARE KATHLEEN VASIL CHECK AMOUNT: $********64.00*
CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK NUMBER: 304871
CARMEL IN 46033 CHECK DATE: 11/03/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 110216 64.00 FOOD & BEVERAGES
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
VOUCHER NO. WARRANT NO.
KATHLEEN VASIL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
3779 SIMMERMAN CT IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CARMEL, IN 46033 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$64.00 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Course Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
Halloween Event 42-390.40 $64.00 1 hereby certify that the attached invoice(s),or 10/29/16 Halloween Event Banquet Tip $64.00
Tip 2016 Tip 2016
1207 101 bill(s)is(are)true and correct and that the 1207 101
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday, November 01,2016
v
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
w
CITY OF CARMEL Expense Report (required for all travel expenses)
NDIANj EXHIBIT A
EMPLOYEE NAME: � DEPARTURE DATE: Ib-a9-l� TIME: AM/PM
'
DEPARTMENT: 1�Y'o riz, RETURN DATE: - TIME: AM/PM
REASON FOR TRAVEL: DESTINATION CITY:
EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging isc. :•'Total .;:,;
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
u•a -If'O 00
r7-77T..
DIRECTOR'S STATEMEN hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
i r ,
Director Signature: � Date:
City of Carmel Form#ER06 Revision Date'10/17/2006 Page 1