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322561 03/12/18
+u,.CAAb ��/ �: CITY OF CARMEL, INDIANA VENDOR: 368806 ONE CIVIC SQUARE KATHRYN LUSTIG CHECK AMOUNT: $**......12.00* f ,� CARMEL, INDIANA 46032 160 CARMELVIEW DR CHECK NUMBER: 322561 9M, CARMEL IN 46032 CHECK DATE: 03/12/18 ., �TpN DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4343002 12.00 EXTERNAL TRAINING TRA VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 368806 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER KATHRYN LUSTIG IN SUM OF$ CITY OF CARMEL 160 CARM ELVI EW DR 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 46032 Payee $12.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Engineering 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 0 43-430.02 $7.00 1 hereby certify that the attached invoice(s),or 3/6/18 0 Parking for Road School at Purdue $7.00 2200 2200 2200 2200 0 43-430.02 $5.00 bill(s)is(are)true and correct and that the 3/7/18 0 Parking for Road School at Purdue $5.00 2200 1 2200 1 materials or services itemized thereon for 2200 1 2200 which charge is made were ordered and received except Monday, March 12,2018 Jeremy Kashman Director 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 of N CITY OF CARMEL Expense Report (required for all travel expenses) EXHIBIT A EMPLOYEE NAME: I,�Q-Le Lu S}`9 DEPARTURE DATE: S16) '1/-+ TIME: $ 3o 6M-)l PM DEPARTMENT: RETURN DATE: ZA-, TIME: 4=30 AM P REASON FOR TRAVEL: PUldue oc�d sch oo I DESTINATION CITY: L04WA-Ett-e EXPENSES ARE FOR(check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Date Transportation Gas/Tolls/ Lodging Meals Misc. Total . ; Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 3/6/18 $7.00 3/7/18 $5.00 $0.00 $000 $0.00 $0.00 $0:00 $0:00 .$0:00 $0::00 " :$0:00 $0:00 $0.00 $0.00 $0,00 $0:00 a $0:00. $0:00 Woo 0.00 $000 $0':00 $0.00 :;$12..00 :':;$.0;00 $0,001 _W001 $0;00 $0:00 ::`;:$0:00 $0;00 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. D recfor Si nature: ? Date: 3-1 Z-19 City of Carmel Form#ER06 Revision Date 3/8/2018 Page 1 For advance payments, claim form must be submitted ten (10) business days in advance of travel. Claim will not be processed without the following documentation: 1) Conference or course registration form, if applicable 2) Travel itinerary or car rental agreement, if applicable 3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt) Prorated meal allowance: For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in-state travel and $65 for out-of-state travel For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in-state travel and $32.50 for out-of-state travel For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in-state travel and $32.50 for out-of-state travel For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in-state travel and $65 for out-of-state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of$ 1-) •00 , such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen. I understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to: 1) Submit original itemized receipts to the office of the Clerk-Treasurer documenting all meal expenditures; and 2) Return all unused funds to the office of the Clerk-Treasurer I further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: 3161'8 City of Carmel Form#ERO6 Revision Date 3/8/2018 Page 2 3/8/2018 Transaction Details Transaction DetailsRU� 3/7/2018 Pa.vki`y R 0 c.-d Eff.3/6/2018 s c►-.o 0 1 WITHDRAWAL @ 8220_PU HARRISON PARKING GA PU H ARRISON PARKIN WEST LAFAYETTINUS Trace#950 0544 -$7.00 Hide Memo/Categorizations MEMO (No memo text) CATEGORIES Education $7.00 Generated on 3/8/2018 8:25:37 AM ©2018 FORUM Credit Union.All rights reserved. haps://www.forumcuonline.com/History/PrintTransaction 1/1 3/7/2018 Purdue University-Payment Receipt Purdue Parking Helping Boilermakers navigate campus Porkies � Payment Receipt Rom, srcvno► Your transaction is complete.Please print the page for your records. -:k It Purchased Items ,1 QTY 1 TYPE Permit Visitor Permit-[VIS113182](03/07/2018-03/07/2018) rt DESCRIPTION Valid for dates:03/07/2018-03/07/2018 Valid for vehicles:407Y,2014,Kia �arnouNr $5.00 Total Paid:$5.00 Transaction Summary CC Receipt Number 20180307000007 Payment Method Credit Card Payment Date 1 03/07/2018 08:23:07 AM Print Receipt Logout https://purdue.t2hosted.com/crt/receipt.aspx 1/1