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Home My WebLink About305051 11/14/16 y��.&inti CITY OF CARMEL, INDIANA VENDOR: 371105 `/ `l CHECK AMOUNT: $********40.00* .�; ® �• ONE CIVIC SQUARE AMY WOOCK i•. _�. CARMEL, INDIANA 46032 686 NOTTINGHAM COURT CHECK NUMBER: 305051 9M�roii'�O� CARMEL IN 46032 CHECK DATE: 11/14/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 854 367006 110916 40.00 MAYOR'S YOUTH COUNCIL VOUCHER NO. WARRANT NO. Prescribed by State Hoard of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER AMY WOOCK 686 NOTTINGHAM COURT IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CARMEL, IN 46032 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $40.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Community Relations 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 RECEIPTS 3-670.06 $40.00 1 hereby certify that the attached invoice(s),or 9/28/16 RECEIPTS $40.00 1203 854 1203 854 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, November 09,2016 ( 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 <1 'r Reimbursement Expense Receipt Reimbursement expenses are transactions that were conducted by a third-parry whom needs a reimbursement on behalf of the CMYC organization_ Transactions such as CMYC members paying for CMYC event materials would be one example of a reimbursement expense. After completing this form, please submit it to the Council Clerk-Treasurer. Expender: �C) J Vendor(location of purchase): i Date: 0 f Cj Event/Activity (if applicable): T Y l S r„„ „ Expense Account(see list of accounts): Additional Description: - ' $5 ,-(D 0 q(- J Expense Amount(do not include Sales Tax): t Reimbursee Name: /�,,,,, r A I D C Reimbursee Address (required): (0�-(O I v ( VI G llwry� 0— I verify to the best of my knowledge that this information is correct, and this purchase was made on behalf of CWC and not for personal use or gain. ender Signature Date Please submit this form to Clerk-Treasurer along with the purchase receipt. Appendix 14-Page 1 Q Tasteb :good is good 12697 North Pennsylvania Carmel IN 46032 (317) 844-4742 Host: Emalee 0c,'ZC,/2016 ORDER-#509 +3 PM 10410 New Gift Card 5.00 / XXXXXXXXXXXX8523 Tran:213668 Auth:336077 New Gift Card 5.00 XXXXX.`y`.XXXX5725 V 0 r� Tra, : ,ga Auth:253�55 New Gift Card , — 5.00 XXXXXXXXXXX7' 4 T ran:215066 +r a �q 'Auth:545344 New Gift Card 5.00 XXXXXXXXXXXX2359 Tastes good is good Tran:943899 Auth:525522 12697 North Pennsylvania New Gift Cartl5.00 Carmel IN 46032, XXXXXXXXXXXX0689' . (317) 844-4742 Tran:940396 Host: Emalee 09/28/2016 Auth:972944 ORDER4511 8:45 PM New Gift Card 5.00 10412 XXXXXXXXXXXX1638 Tran:214223 Nev; Cift Card- 5.00 Auth:365333 XXX'XXXXXXXX2415 New Gift"Card 5,.00 ran:941603 XXXXXXXXXXXX4212 Allith:812166 Tran:214689 Auth:799000 Uht otal 5,00 Tax 0.00 Subtotal 35.00 Tax 0.00 TAKE OUT Total 5.00 Discover #XXXXXXXXXXXX9273 5.00 TAKE OUT Total 35,00 Authorizing. .-. Discover #XXXXXXXXXXXX9273 35..00 Balance Due 5.00 Authorizing. . . Balance Due. 35.00 Order online at� chipotle.com Order online at chipotle.com