HomeMy WebLinkAbout332440 11/21/18 CITY OF CARMEL, INDIANA VENDOR: 212690
® °;• ONE CIVIC SQUARE SCOTT MOORE CHECK AMOUNT: $********22.49*
CARMEL, INDIANA 46032 14200 AUTUMN
4 GOODS DRIVE CHECK NUMBER: 332440"
CHECK DATE: 11/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 22.49 GASOLINE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 212690 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
SCOTT MOORE IN SUM OF$ CITY OF CARMEL
14200 AUTUMN WOODS DRIVE 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.
WESTFIELD, IN 46074
Payee
$22.49
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police 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 42-314.00 $22.49 1 hereby certify that the attached invoice(s),or 11/16/18 0 reimbursement for gas purchase $22.49
1110 101 1110 101
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
Tuesday, November 20,2018
Jim Barlow
Chief
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
CITY OF CARMEL Expense Report (required for all travel expenses)
. �NDIANp
EMPLOYEE NAME: Scott Moore DEPARTURE DATE: 11/16/2018 TIME: 2:30 AM/PM
DEPARTMENT: Police RETURN DATE: 11/17/2018 TIME: 145 AM/PM
REASON FOR TRAVEL: Security for CHS Semi State Footba DESTINATION CITY: Valporaiso Indiana
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Transportation a /Tolls/ Meals
Date Parkin Lodging Misc. Total
Air-fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
11/17/18 $22.49 $22.49
$0.00
$0.00
. $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
Total $0.001 $0.00 $0.00 $22.49 $0.001 $0.001 $0.001 $0.001 $0.001 $0.001 $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.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 11/19/2018 Page 1
V�U"
WELCOME
DATE 11/16/18 22:12
IRAN# 9027564
PUMP# 02
SERVICE LEVEL: SELF
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GALLONS: 9,(?00
PRICE/G: $ 2,.499
FUEL SALE ; 22.49
CREDIT $22.49
MASTERCARD
XXXXXXX.XXXXX6877
Entry Method:Swiped
Auth #: 04480P
Resp Code: 000
Stan: 02441486645
Invoice #: 336236
BP SITE ID: 8726259
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XXXXXXXXXXXX6877
Stan: 02441486645
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