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308441 02/22/17 / CITY OF CARMEL, INDIANA VENDOR: 371285 ONE CIVIC SQUARE NIKKI VASIL CHECK AMOUNT: $*******165.00* ,. CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK NUMBER: 308441 M?Ftiri CARMEL IN 46033 CHECK DATE: 02/22/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 165.00 FOOD & BEVERAGES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 371285 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER NIKKI VASIL IN SUM OF$ CITY OF CARMEL 3779 SI MMERMAN CT 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. CARMEL, IN 46033 Payee $100.00 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 Shepard Center 42-390.40 $100.00 1 hereby certify that the attached invoice(s),or 2/16/17 Shepard Center Banquet Tip $100.00 Tip Tip 1207 101 bill(s)is(are)true and correct and that the 1207 101 materials or services itemized the`eon for which charge is made were ordered and received except Friday, February 17,2017 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 9 CITY OF CARMEL Expense Report (required for all travel expenses) ,�(ND•IAN% EXHIBIT A EMPLOYEE NAME: N !'k k-Iyo s I DEPARTURE DATE: — �P �� TIME: AM/PM DEPARTMENT: RETURN DATE: TIME: AM/PM REASON FOR TRAVEL: DESTINATION CITY: EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Misc. ;'Tof 1, Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem d 116t 17 Tj�j 1100 " i•::' y" l,•1 i..4•� '•Ir' :l:"`: Ot (h777777777 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: City of Carmel Form#ER06 Revision Date 10/17/2006 Page 1 VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) Vendor# 371285 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER NIKKI VASIL IN SUM OF$ CITY OF CARMEL 3779 SI MMERMAN CT 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. CARMEL, IN 46033 Payee $65.00 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 Pete Banquet Tip 42-390.40 $65.00 1 hereby certify that the attached invoice(s),or 2/11/17 Pete Banquet Tip Pete Banquet Tip $65.00 1207 101 1207 101 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 Thursday, February 16,2017 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 CITY OF CARMEL Expense Report (required for all travel expenses) ��;NOIAN% EXHIBIT A EMPLOYEE NAME: N�\\�- 0.S' DEPARTURE DATE: � ��/ TIME: AM/PM DEPARTMENT: 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 Mise. Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 14, i -.777777 T*i i DIRECTOR'S STATEMENT• hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: a City of Carmel Form#ER06 Revision Date 10/17/2006 . Page 1