HomeMy WebLinkAbout331326 10/17/18 y u'�,A� CITY OF CARMEL, INDIANA VENDOR: 372848
(= ONE CIVIC SQUARE ROGER MANSFIELD CHECK AMOUNT: $ 20.72
''' 25 BEXHILL DRIVE CHECK NUMBER: 331326
�� /,r CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK DATE: 10/17/18
M�[J'ON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 REIMB 20.72 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# Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Mansfield, Roger Payee
25 Bexhill Dr
Carmel, IN 46032 In Sum of$ Purchase Order#
Mansfield, Roger Terms
$ 20.72 25 Bexhill Dr Date Due
Carmel, IN 46032
ON ACCOUNT OF APPROPRIATION FOR
101-General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1125 Reimb 4343000 $ 20.72 Board Members 1014118 Reimb Travel Expenses for Core Exam $ 20.72
I 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
$ 20.72 Total $ 20.72
October 9,2018
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
I OT31;0 101:�poelialo �il /, 0-7 (�M-tf &40
10(3 j$
1 o(3C(o t4rwfipE A2601A)K c� J�, (7
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $0.00
Employee Name(print)( OC
6a3a-
......1 .. ..
20
Address . .Check BY.
payable to: City, St,Zip /,Pj
Signature: . Approved by:
Date: Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
V
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Subway#1103-0 Phone 765-743-0889 ILafa"y tt ��IN�� 01
Lafa��ette, IN 4�9G1
135 South Chauncy Ave Suite 2S 165-742-2591
385
Nest Lafayette, IN, 47909 www.lafayettebreutingco.com
Served by: 21214 10/3/2.018 11:52:13 am
Term ID-Trans# 1/A-495373 TABLE # 31
SPLIT 1
BUY ONE GET ONE FREE QUARTER POUNDER Qty Size Item Price CHECK# 385373.1
W/CHEESE OR EGG MCMUFFIN --- - .";; ""--- ----- QATE/TIME: 10/3/'2018 5:49:24 PM
Go to www.mcdvoice.com within 7 days 1 6 Cold Cut Combo Sub 4.39 S RAR: Daniel
and tell us about your visit. 1 -Fresh Value Meal (21-1) 2.60 STATION: 03
- -21oz Fountain Drink PARTY SIZE: 2
Validation Code:
Expires 30 days after receipt date. -Chips Iteal'count: 1
Valid at participating US McDonald's.
S
Survey Code: ih Total 6.99 1 .000 IN CLUB*
GE-;neral Sales Tax (7�) 0.49 $9"'0
04848-03851-00318-07557-00010-7 , +al VL Subtotal
(Fat Tn) 50
7.48 $9
VV Tax � 0
McDonald's Restaurant #4848 Cash 8.00 Total before trip: C'7
Change 0.52
613 SAGAMORE PKWY W Tip amount:
WEST LAFAYETTE, IN 47906-1441 Was it Perfect? — — -- �-�c7
TEL# 765 497 4663 MAKE IT A GREAI DAY Grand total :
Brittany
KS# 3 10/03/2018 07:55 AM 765-743 uaiW)
Sidel Order 85
Host Order 7.D: �a'hl:�.��? j IiiCi3115213 SALE
1 Sausage Biscuit 1 .00 Hungry for iru iu' 1.0.-sls know how we did VIS ********* *
- :�00 ENTRY METHOD: CHIP
Subtotal today by taking our 1 �ri�iiutr Survey at j
Tax 0.07
wttw.subwayiistens.cam, and receive a DATE: 1OJ03J2018 TIME: 17:49:27
Take-Out Total 1 07 Subprise offer to use with your next INVOICE: 6810
purchase. REFLi"FNCE: 0040
2.00
� Arf► CODE: 08229C
Cash Tendered AMOUNT US
Ds 0.93 USD$ i0. ;
I'OTAL USD$ 1'i
MCDona l d'.s.,Restac!r�nt::.
- APPROVED IHANK YOu
_ = I AGREE TO PA'.` ilii
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