Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout324310 04/25/18 <- CITY OF CARMEL, INDIANA VENDOR: 360484
i dI ONE CIVIC SQUARE AMY BALDAUF CHECK AMOUNT: $***'***183.23`
CARMEL, INDIANA 46032 126 LARK DR CHECK NUMBER: 324310
APT D . CHECK DATE: 04/25/18
CARMEL W 46032
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 183.23 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 360484 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Baldauf,Amy Payee
126 Lark Dr.,Apt D
Carmel, IN 46032 In Sum of$ Purchase Order#
360484 Baldauf,Amy Terms
$ 183.23 126 Lark Dr.,Apt D Date Due
Carmel, IN 46032
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#ornvoice Description
Dept# INVOICE NO. ACCT#f TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 Reimb 4343000 $ 183.23 Board Members 4/3/18 Reimb Travel Expenses NAA Annual Convention $ 183.23
1 hereby certify that the attached invoice(s),or
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
$ 183.23 Total $ 183.23
April 17,2018
1 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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Carmel . Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
1 r6 N' s �Oo t s-ficl(bau:ks osf-q� 46'-X66 v I'C Wli FdPSt , I I o vp 1
31W Ips q) UZZ 's CCLKfin
►�I►g -, cam . �-�
II-9 19 CVS �WMQS �0 � , 9 UV
3hq jj� r ff b LAL S .,S5, r- AMAI
035- F
1�1 19 Nl a n�eA- ffic R Z-0
3�:35�- 14
2� I� �woo�fi C0f jam.lave, G C�
All receipts should be attached in the same order as listed above. -�,
No sales tax will be reimbursed. TOTAL: :�3,w!: � d
Employee Name(print) G. Gt
Address �'- - �
Check /�
payable to: City, St, Zip /C-3x-
Signature:
C-31
Signature: ' Approved by: 4
Date: its,
Date: d,4
Business Services Division,Revised 7-7-08 F 4' � s
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
APR 1 6 2018
BY:
Carmel ® Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
1 Ipl�� 3 G6O ��GtY�I � ��X
zbIt Lk C% MCA, 7
2- -13
Z l< i o afAa-rte 7® �s
-3(( W�*C� �-A C, -IV m PaYT-'k P2
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $9:9
Employee Name(print)
Address ��
Check
payable to: City, St, Zip CO����.I ► ,�/ �T lL1�J�
Signature: I J Approved by: ,(? q
Date: `�T Date: �" I J 4
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
METRO CAFE DINER g345WO
229 Peachtree St °
Atlanta, GA 30303 #*CVS p h'e'r m Cavy
404-577-1420 Metro Cafe Diner
229 Peachtree St NE 6-17 235 PEACHTREE STREET NE
Server: Robert 03/18/2018 Atlanta, GA 30303 ATLANTA, Gn 30303
Table 62/1 11:31 PM (404) 577-1420 go4;577.4054
Guests: 4 30156
Menu: Server 03/18/2018 23:39:14 REG#06 TRN#5812 CSHR#1513943 STR#10043
SubTotal .y SL9�USD 7.02
Straw Short Ca 6.45 Helped by: DONNA
h �Co Al T USD $�I A ExtraCare Card # # * # #*$351
Complete Subtotal 6.45 All
Tip
! Total - USD $ D PRSD STWBRY 1.2Z 2,098
1 Items Entry Method: Chip Z,09 EACH 3 DR MORE 2.00 ERti
4 VISA DEBIT XXXXXXX XXX31 I ICE BRKR CP SPRM 40CT 4.498
l 6.45 E CARD #: - APPROVED I 9`
Subtotal 0,57 i PURCHASE 1 CVS FIRST RID KIT 30CT 2.99T _�'�
Tax AUTH CODE:014723
i 3 ITEMS
Total ' 7.02 Issuer SUBTOTAL 9.57
Mode: Aoo00000031010 GR 8,9% TRX .27
AID;
8000008000 GA 4,9% TRX
Balance Due 7 . 02
32
TVR: 06010A03602000 TffAL 10.16
10.16
Thank You For Dining With Us IAD' ARC: 00 DEBIT CH
TSI: 6800, ** * s141
MID. 8747880 TID: 636282 RRN: 122199 US DEBIT * *** * 3141
REF# 068128
TRAN TYPE: SALE
Signature: RID: 80000000980840
TC: DE21642ER0273EO9
I agree to pay a ove total amount TERMINAL# 69066689
according to card issuer agreement. PIN VERIFIED ONLINE
(Merchant agreement if Credit Voucher) CVM: 420000
TVR(95): 8080048000
Retain this copy for your records TSI(9B): 6800 i
CUSTOMER COPY CHANGE .00
THANK YOU FOR
SHOPPING WITH U III��IIi.II �I��i�� ► . .:..
SHOPP III�II�II . .
Ips `1 f Res -T1-CLv1 Pe-t e� s
Market
Welcome to Chick-fil-A Hyatt Regency Atlanta
& & & 405 & & & Peachtree Center (#00238) A t 1 a n t a, G A
ATLANTA MARRIOTT MARQUIS Atlanta, GA
* ** STARBUCKS **** (404) 577-4194
136245 VERONICA Operator: Gary Branch Hyatt-POS
•-----------•------------'-"------------- I' CUSTOMER COPY � 265 Peachtree St N E•,A t 1 a n t a, G A
CHK 51623/19/2018 10:47:43 AM 30303 C� e�
19 Mar'18 11:04 AM
�' ,j � CARRY OUT �: . ' �' 404-577-1234
-------•---------------------------------
TAZO TEA BTL 3.15 r Order Number: 4504915
1 j..
1 .95 l` SERVER 2309 Yayineab
1 CHIPS l 1 Meal-Nugg 8ct 6.49 TYPE PRE AUT H
ACCOUNT TYPE Visa
FOOD $5.10 NuggstMBct CARD NUM37R ** * ** *3141
Tax: $0.45 0.26 DATE/TIME 03/19/2018 09 : 15
Tota l ; $5 . 55 Lmnde MD
4;0 : gg
{ REC # 001887
iChar-lge Due ,
STAF;BUCKS REDEEM $5.55
Sub. Total:
$6.75 INV/CHK # 4 0 3 0 '
Tax: $0.60 REFERENCE # MG0934232165
************1466Tota 1: $1.�b f SEQUENCE # 507
Authorization: 284399 AUTH . # 071509
Balance: 5.85Change $0.00 ENTRY METHOD CHIP
Visa: $7.35
____ ___ Register:? Tran Seq No: 4504915
----------- Check Closed --- -----------------
19 9 2 6 E`
Mar'18 11:04 AM - Cashier:Jeanette TOTAL It was a pleasure serving you!
Have a wonderful day. _
Forgot to scan the app? TIP : ---------
www.chick-fil-a.com/forgot2scan
3
TOTAL : ----
"
Visa �•
Card Num XXXXXXXXXXXX3141 APPROVED - THANK YOU
U
Terminal KA13348984007 BALDAUF/AMY E
Approval : 044710 ,E
Sequence : 009821
M
DDE Issuer
PP VISA DEBIT .
— AID A0000000031010
TVR 8080008000
TSI 68nn
ARG �
gyf3oao
iia vel Fees t� i� ; avel
�-Tv'
L ; r' I
5I1K
N
1
1075 Peachtree St
Arlan+.,. 13A 30309 � � �- 1075 Peachtree St
Atlanta, GA 30309
e: Mar19'18 09:06PM
044 Sarah L Dat
E
.._. _______ . _ Card Type: Visa
205/1 Chk 5523 u. 1 Acct #: XXXXXXXXXXXX3141
Mar19'18 07:50PM Card Entry: SWIPED C� L
*** Reprint Memo Check *** Trans Type: PURCHASE
_ ____________________ ----------- Trans Key: KIK006941857705 ,v
O n e I n l Auth Code: 000621
Seat:8 Check: 5923
Stella Artois� ' 7.00 f Table: 205/1
1 8oz Skirt 27.00 Server: 1044 Sarah L
1 STK 2.00
Mac & Cheese 10.00 Subtotal: 49 . 9 2
Subtotal 46.00
Tax 3.92 { A Gratuity for the food
09:01PM Total 49 . 92 service team has not been
added to your check. If
you are happy with the service
�I �
A Gratuity for the food We can add:
�(�
service team has not been
added to your check. If 18% is $8.99
you are happy with the service 20% is $9.98
Wer , add: 22% is $10.98
Please intial next to selection
;. 2w
18% is $8.99 Thank You!�
20% is $9.98 Tip: r
22% is $10.98
Please int'ial next to selection ! Total:
-_Thank You! '
Keep for your records
*CUSTOMER COPY*
1 q-3
Tave.,i Edgewood Corner Tawe rn
464 Edgewood Avenue
Edgewood Corner Tauer�n Atlanta GA 30312
464 Edgewood Avenue 404- 77-2310
Atlanta GA 30312
404-t77-2310 j 1007408
Yanna STable: 32
Yanna S Table: 32 03/20/2018
03/20/2018 Gst 7 05:57 PM
05:52 PM 1007408 Sale Num: 772323
Seat: 7 - ___ _ ---- --- ---- ------
Name AMY E BALDAUF
1 MN On a Boat 16oz5 J0 � CC Tyype Visa
1 Frychos 5.50 Accnt No: xxxxxxxx3141 -
�J Auth No 095717 ( G7
Source Swiped
1
SubTotal: 13.50 '
Sales Tax: .71 1 Almunt 16A1
91
Total: 14.21 °
20% Sry Charge: 2.70 Tip W
Grand Total : 116.91 Total $ -116,_q_
G .
i
I Ai' TO PAY ABOVE TOTAL AMOUNT
Tip Guide ACCORDING TO CARD ISSUER AGREEMENT
15%: 2.20 (MERCHANT AGREEMENT IF CREDIT VOUCHERED)
20%: 2.93
25%: 3.66
Y
Thank Yoii:
163 -`I
JI 5q3e a rix a�rs� 10-Cl
I 433 06
South City Kitchen Buckhead
404.815.6677
3350 Peachtree Road South City Kitchen Buckhead
Atlanta, GA 30326 404.815.6677
404-615-6677 3350 Peachtree Road
Atlanta, GA 30326
Server: Jodie DOB: 03/20/2018 ,1 404-815-6677
09:22 PM 03/20/2018
3/30043
Table 41/2 Server: Jodie 03/20/2018
s Table 41/2 9:15 PM
SALE Guests; 0 30043
Order Type: ORDER
Mastercard 2097168 �' Area: Restaurant
Card #XXXXXXXXXXXX8148
Magnetic card present: BALDAUF AMY E GateCityCopperheadDftl?e � 6.00
Card Entry Method: S Fried Chicken 20.00
Angel Pie 9.00
Approval: 36857W
Amount: $ 38.12
Complete Subtotal 35.00
3Items
+ Gratuity:
��b x
Subtotal 35.00
Total: _— Tax 3.12
Total 38.12
I agree to pay the above
total amount according to the Balance Due 38 . 12
car issuer agreement.
Visit us at:
X www.fifthgroup.com
Visit us at:
www.fifthgroup.com
# GUEST COPY
�IL30�r� --avec
lyAVeA Fees tEilix R3
Atlanta Breakfast Club
249 Ivan Allen Jr, Blvd NW
e e Atlanta, Georgia
j United States, 30313
Tel:470-428-3825
Atlanta Breakfast Club Printed March 21, 2018 at 11:27 AM
249 Ivan Allen Jr, Blvd NW
Atlanta, Georgia - Order ID: 36515
United States, 30313 Type: Authorize
Tel:470-428-3825 DateMme:3/21/18 11:27 AM
Printed March 21, 2018 at 11:18 AM
Server: Ivan
March 21, 2018 at 11:18 AM
Table: 10, , 6 guests i Card Number: XXXXXXXXXXXX3141
Waiter: Ivan Account Type:VISA
Seat(s): 4 I Auth ft:092611
Ref#:
Peach Cobbler French Toast $10.95 I
Chicken Sausage Gravy $3.00
Biscuits (2) $2.50 �. APPROVED -THANK YOU
Regular Coffee $2.25 c
Split Items (1/6) ! �{ 7(D
Subtotal:$23.73
Food Total $18.70
Sub Total $18.70 �. Tip:
Sales Tax 8.9% $1.66
Service Fee (18%) $3.37 Total:_ J 3
Total23.73
$ Important-retain this copy for your records
In ATL eat ABCI ...CUSTOMER COPY.—
Thank you for dining with us.
54SO00
OPERATED ON
�I q , rvces 1`L K zl
.��II IIlri,llr�l�1l i WELUU ME TO
IMCPL
PINO GELATO
ATLANTA INTERNAT"'.ONAL AIRPORT ' PLEASE KEEP THIS TICKET
WITH YOU
210079 N e k 1 s 1 C 1 + Entered/Arriuee:
_ __ __ . -_ -_- ____ 2018/03/12 11:25
C H K 200 Ticket/Billet#:39643575
MAR 21 ' 1 EI ;? :5 2 F M Our/Duree:2:23:38
------- _,.-.------ -,- --- _--_ i Paid On/Paye Le:
--------- 2018/113/1213:49
TO GO
I. Paid/Paye:$ 3.00 „
1 LG CUP L 15 .99 'l original Fee:$ 3.00
GST:$ 0-00
I PST:$ 0.00
SUBTOTAL �-1 .913
FOODTX ADD207001 0 .56 change:$ D.00
r r UIS$
AMOUNT PAID -7 -� -�� sc:$ 0.1111
AT025214 XXX3' 41
VISA CC 2 .5 7 Merchant ID:****"******6235
****"******6235 S
--210079 Closed MAR21 (:2 :';.2PM---
UIS$
WE WANT TO HEAR YOUR FEECIBACK! Seq# 000023 884
PLEASE CONTACT 1 --1377--1:72-74.57
OR CUSTOMERSER4'I(;E(�HM;:HOST .1-IOM Purchase 18/03/12 14-07.21
TO SHARE YOUR EXPERIENCE . Auth# 958454
STOREID : AT LPGO(, 1 APPROVED