327018 07/03/18 +d C�qb
CITY OF CARMEL, INDIANA VENDOR: 372133
ONE CIVIC SQUARE VALERY DE LONG CHECK AMOUNT: $*******1 16.74*
,a; CARMEL, INDIANA 46032 56 KNOLL COURT,APT D CHECK NUMBER: 327018
°M��ioN�o. CARMEL IN 46032 CHECK DATE: 07/03/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4343004 23.44 TRAVEL PER DIEMS
1203 4359300 93.30 ECONOMIC DEVELOPMENT
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 372133 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VALERY DE LONG IN SUM OF$ CITY OF CARMEL
56 KNOLL COURT, APT D An invoice or bill to be properly itemized must show:Idnd 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
$116.74
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
RECEIPT 43-593.00 $79.30 1 hereby certify that the attached invoice(s),or 6/20/18 RECEIPT $79.30
1203 101 1203 101
RECEIPT 43-593.00 $14.00 bill(s)is(are)true and correct and that the 6/20/18 RECEIPT $14.00
1203 101 materials or services itemized thereon for 1203 101
MILEAGE CLAIM 43-430.04 $23.44 which charge is made were ordered and 6/21/18 MILEAGE CLAIM $23.44
1203 101 g 1203 101
received except
Monday,July 02,2018
`/IA,, -•ccs/ Y.
Heck, Nancy
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
EMPLOYEE REIMBURSEMENT
Sales tax is not reimbursable
NAME: Valery De Long
ADDRESS: 56 Knoll Court,Apt D Carmel, IN 46032
TOTAL AMOUNT OF RECEIPT(S)ON THIS PAGE: $95.49
PURPOSE OF EXPENSE: Parking and Food
Use separate sheet for different purposes or events,as account coding may vary
AFFIX ORIGINAL RECEIPT(S) BELOW OR ATTACH,IF RECEIPT IS FULL PAGE
$14.00 -Parking for IEDC Host Committee meeting on 6/20/18 -Salesforce Tower,Indianapolis
°19,30 _$8149.-Food for meet&greet between CRED,City Council and Rob DeRocker on 6/20/18
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.............
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.Pacers'
OlhCial Grocery Stere of the Indiana Pace:-,. _
1217 S. RANGELINE RD,
317-846-4818
Your cashier was ROBERT
KRO NAPKINS 1.79 TExpress Park
KRO CUTLERY 0.99 T 20 N. Pennsylvania St.
CTO FOAM PLATE 0.89 1 Thank You for Parking
BFG BROWNIE WLNT 5.99 F With Us.
DORITO CHIPS 1.69 F DATE: 06/20/18
SUNCHIPS SNACK 1.69 F TIME: 03:39 PM
DORITO CHIPS 1.63--F * Original *
DORITO CHIPS 1.69 _ Receipt No. 73/662/211
LAYS CHIPS 1.69 D
LAYS CHIPS 1069 B Ticket - 132260
LAYS CHIPS 1.69 B LPR = UKM891
SUNCHIPS SNACK 1.69 F TAX included 14.00
SUNCHIPS SNACK 1.69 F .
DELI CKN 12.99 T"
Credit: 14.00
--RST-BF-PINWHFFL 4.49-B Trans ID : 89705
PNWHL COMBO PLTR 14.99 F . Card No.
LRG UEG TRAY 10.99 F Card Type: MASTER CARD
SABR HUMMUS 4.99 F
ICE MTN WATER 2.99 F
ICE MTN WATER 2.99 F Entry - 06/20/18 09:06 A:ti
KROGER PLUS CUSTOMER *******8789 Valid— 06/20/18 03:39 PM
1 .
0** BALANCE BTA,
CARMEL IN 46032
MasterCard Purchase
************1148 - C
REF#: 66122P TOTAL: 81.49
AID: A0000000041010 �5 G J
TC: FOE9ED89DA87542A �=-
MASTERCARD 81.49
CHANGE 0.00
TOTAL NUMBER OF ITEMS SOLD = 20
06/20/18 05:48pm 959 9 126 129
JUNE FUEL POINTS
FUEL'POINTS THIS ORDER = 79
FUEL POINTS THIS MONTH = 82
THIS MONTHS POINTS EXPIRE 7/31/18.
Annual Card Savings $5.32
Now Hiring - Apply Today!
jobs.kroger.com
www.kroger.com
Prescribed by State Board of Accounts
MILEAGE CLAIM
City of Carmel, Indiana TO Valery De Long
(Governmental Unit)
Dept. of Community Relations & Economic Development On Account of Appropriation No. for
(Office,Board,Department or Institution)
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES
12g 18. Point Point Start Finish TRAVELED
3
Auto License No. TOTALS
*SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953, 1 hereby certify that the foregoing account is just and correct,that the amount claimed is I ,
allowing all just credit , and t at no part of the same has been paid.
Date �/ tJ