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Home My WebLink About331327 10/17/18 a u,_C�N�I a'/ �4� CITY OF CARMEL, INDIANA VENDOR: 372838 `1 ONE CIVIC SQUARE CODY MCCOLLUM CHECK AMOUNT: $********22.98* 49� �,, CARMEL, INDIANA 46032 8766 GARONNE TERRACE CHECK NUMBER: 331327 �'„roN'�. APT 3C CHECK DATE: 10/17/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4343000 REIMB 22.98 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show,kind of service,where performed,dates service rendered,by Vendor# 372838 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. McCollum,Cody Payee 8766 Garonne Terrace Apt.3C Indianapolis, IN 46250 In Sum of$ Purchase Order# 372838 McCollum,Cody Terms $ 22.98 8766 Garonne Terrace Apt.3C Date Due Indianapolis, IN 46250 ON ACCOUNT OF APPROPRIATION FOR 101-General Fund PO#or Invoice Description Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1125 Reimb 4343000 $ 22.98 Board Members 10/4/18 Reimb Travel Expenses for Pesticide Training $ 22.98 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 $ 22.98 Total $ 22.98 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 10/3/2018 McDonald's Il - t7OD $ 4.80 Breakfast 10/3/2018 Subway $. �. 8.01 Lunch 10/3/2018 Lafayette Brewing Co. $ G 10.17 Supper IAll receipts should be attached in the same order as listed above. lMo sales tax will be reimbursed. TOTAL: $22.98 77 W 1 Employee Name(print) - Cody M. McCollum OCT 0 9 2018 Address 8766 Garonne Ter. Apt. 3c BY: Check x -•,� payable to: City, St, Zip Indianapoils, IN, 46250 Signature: � ��_- Approved by: Date: ,y/L� J Date: G� Business Services Division,Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request .:`.W/1;I11i1:3.JG.,l7(1_tltll GO tG"WWF; [clvtflGE Lfig{,W1,t111tT ✓ i�JyS ald',ii l l-'iis=dti�ut:your visit: " ,t Va 1 i dat i on Code: ----------- ------------- Expires 30 days after receipt date. Valid at participating US McDonald's. Subway#1103-0 Phone 765-743-0889 Survey Code: 135 South Chauncy Ave Suite 2S 04848-03841-00318-07543-00048-0 West Lafayette, IN, 47909 Served by: 21214 10/3/2018 11 :51:46 am McDonald's Restaurant #4848 Term ID-Trans# 1/A-.495372 613 SAGAMORE PKWY W WEST LAFAYETTE, IN 47906-1441t Qty Size Item Price TEL# 765 497 4663 - ---- ---- 1 6" B.M.T. Sub 4.89 lafa ette Nwin� Co, KS# 3 10/03/2018 07:54 AM' 1 -Fresh Value Meal (21-1) 2.60 1 Order 84 � Lafayette, IN 4 901 Sidel - -21oz Fountain Drink 765-742-2591 - -Chips www.lafayettebrewirigco.com 1 Bac Egg Ch McGrdl M1 4.49 Sub Total 7'49 1 M Coke General Sales Tax (7%) 0.52 TABLE # 31SPLIT 3 Subtotal 4.49 Total (Eat In) 8.01 CHECK# 385373 0.31 Credit Card 8.01 Tax 4.80 Change 0,00 DtiTE(TIME: 10/3%2018 5;14:13 PM Take-Out Total Was it Perfect? SERV R: Daniel 4.80 MAKE IT A GREAT DAY PARTYOSIZE: Cashless 0.00 Brittany Scott store manager G Change 765_743_0889 It?fll Count: 3 MER# 192332 I Approval No: 944159 1 .000 SMF&C* ---~- -y=-; " $9.50 1 CARD ISSUER ACCOUNT# Reference No: 827615457710 Debit SALE ************6627 Card Issuer: Mastercard Subtotal $9.50 TRANSACTION AMOUNT •_ 4.80 Account No; ************6627 �nN�YLJ ��fll �$1d'�� CHIP READ Acquired: Conkact_EMV MPC k AUTHORIZATION CODE - 886842 Amount: Debit Application: DDebit MasterCard SEQ# 031500 AID: AOOOOO00041010 Opened: 10/3/2019 5:14:13 PM AID: AOOO0000042203 TVR; 8000008000 TSI: 6800 Thani•: , :,,, for i,i t i,,;� McDonald's Restaurant ,, � Date/Time:. 10 _„-/,,,:.:0,8.11 :`;1:38.. AM I i1 Lafayette IN 4901 765-747.-2691 www,lafayettebrewingco.cpin TABLE # 31 SPLIT 3 CHECK# 385373.3 DATENIME: 10/3/2018 5:49:24 PM SERV R: Daniel STATION: 03 PARTY SIZE: 2 Item Count: 3 1 .000 SM F&C* $9,50 Subtotal X.50 Tax .67 Total before tip: ,17 Tip amount: Grand total : SALE MASTERCARD ************6627 ENTRY METHOD: CHIP DATE: 10/03/2018 TIME: 17:50:22 C/ INVOICE: 6812 REFERENCE: 0042 AUTH CODE: 955088 AMOUNT USD$ 10,17 TOTAL USD$V10�17 APPROVED - THANK YOU -I-AGREE TO PAY 'THE ABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT (MERCHANT AGREEMENT IFC' IT VOUCHER) x---____. APPLICATION LABEL: Debit MasterCard AID: AOOOOO00041010 TVR: 8000008000 IAD: 0110601.00322000000000000000000000OF TSI: 6800 ARC: 00 CVM: SIGN - Opened: 10/3/2018 5:14:13 PM Thank