319037 11/22/17 < +�,CgpyRf
CITY OF CARMEL, INDIANA VENDOR: 364842:• ,
ONE CIVIC SQUARE KATHLEEN VASIL CHECK AMOUNT: $*******213.40*
?� CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK NUMBER: 319037
9M�roN. :`• CARMEL IN 46033 CHECK DATE: 11/22/17
F�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 KVASIL TIP 213.40 FOOD & BEVERAGES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 364842 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
KATHLEEN VASIL IN SUM OF$ CITY OF CARMEL
3779 SIMMERMAN 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
$213.40
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
K Vasil Tip 42-390.40 $213.40 1 hereby certify that the attached invoice(s),or 11/17/17 K Vasil Tip Firefighter tip 9-1-17 $213.40
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
Friday, November 17, 2017
c
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
,20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
.4'twsyCNcq F!
D
CITY OF CARMEL Expense Report (required for all travel expenses)
EXHIBIT A
EMPLOYEE NAME: ci,-+ i ,o, G,LsT 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 Misc.
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem }
t-71 13,
ry. �cc;•.:..;.
7 77
Total
DIRECTOR'S STATEME I hereby affirm th aIkexpenses 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