The URL can be used to link to this page

Home My WebLink About185144 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1 ONE CIVIC SQUARE AMY BALDAUF o CARMEL, INDIANA 46032 126 LARK DR CHECK AMOUNT: $557,52 APT D CHECK NUMBER: 185144 CARMEL IN 46032 CHECK DATE: 5/11/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 REIMB 67.48 GENERAL PROGRAM SUPPL 1081 4.343000 RETMB 490.04 TRAVEL FEES EXPENSE Carmel e Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense 4910 C c A rA 4cl tq\� e-s CV M '4 f 26 10 I�e� Zz All receipts should be attached in the same order as listed above. a Z No sales tax will be reimbursed. TOTAL: i Employee Name (print) °l _L -,11� S M A Y 0" 20 10 Check Address Y 22 payable to: City, St, Zip �OL WI I d quo 2 Signature: f I Approved by: �1 Date: `Jf Date: U I Business Services Division, Revised 7 -7 -08 FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request Carmel Clay Parrs &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense 1 Q�d Ex ress L 3y300 All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: 1 9 I -I Employee Name (print) Address MAY 2010 Check _payable to: City, St, Zip CR f M d I N L A U nZ Signature: P)C( Approved by: Date: I �V Date: Business Services Division, Revised 7 -7 -48 FILE: Shared\AdministrativelForms \Staff Forms \Employee Exp Reimb Request Carrel o Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense HOW�j q0io3l �ktyt(c�l SL�a� 4_ (SI'LA� C' "s 2P') e All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: Employee Name (print) A m s n Check Address (2t; LQ! (fir D _payable to: City, St, Zip a -ej /n( Signature: 4 AA" Approved by: yz Date: Date J Business Services Division, Revised 7 -7 -08 FILE: SharedlAdministrative \FormslStaff Forms\Employee Exp Reimb Request PRESCRIBED BY STATE BOARD OF ACCOUR-M GrNERAL FORW 110. ,01 119M MILEAGE CLAIM" y (OOVERNWENTAL IMM ON ACCOUNT OF APPROPRIATION NO. FOR (OF,WP, BOARD. DEPARTKOff OR nIST MILK FROM TO READING +t AUTO l DATE i r E" r FINISH REAING NATURE OF BUSINESS TRAVELED R M! POINT POINT START PER MILE 5 `L S 5 5 5� AUTO LICENSE NO. TOTALS I�" Z 1 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, I hereby certify that the foTegoing account is just and correct, that the amount claimed is legally due, alter aliowing all just credits r and that no part of the same has been paid. fm T& qpn Date MAY 0 4 2010 D O BIl:.�� O VL FRESCp1RLD BY STATE BOARD Of ACCOUNTS MILEAGE CLAI GENERALfDAL NC, 101 (14957 TO (GOVERNMENTAL UNITE ON ACCOUNT OF APPROPRIATION NO. FOR (OFn= BOARD. 6FPARTbUNT OR 1NSrnW1ON( DATE SPEEDOMETER FROM TO READING AUTO H�1LEA�E i c NATURE OF BUSINESS POINT POINT START FINISH TRAVELER PER MILE 1( G s v PA T yet _I Y 2 r\A M OVX4 ,Z 2 0.r g. Y AUTO LICENSE NO. TOTALS I �J I c� 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 legally due, after allowing all just credits and that no pad of the same has been paid, Date PRBSCRIBED BY STATr BOARD OF ACCOUNR GrNGRAL FORM Bc, 101 11996) MILEAGE CLAIM TO �dn C 4GOVERN34ENrA4 UNrrt ON ACCOUNT OF APPROPRIATION NO. FOR (CORM, BOARD. D[PARTIO R OB TNSTMMONI DATE FROM TO SREDIINM AUTO �E. NATURE OF BUSINESS POINT POINT START FINISH A MR I PER MILE NP\DL 2 5. 1 r -6 5 5 Ma y Y mwal 5- KMY 1 6 S 10 o N\O ff Mrs I 5 7 1 Y) Y 4'f NNXY J? 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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after atiowing all just credits end that no part of the same has been paid. Date PRESCRIBED BY STATE BOARD Of ACCOUMS rWER FORM U0. 101 11986) MILEAGE CLAIMM TO l�M� (GOVERNMENTAL UNm ON ACCOUNT OF APPROPRIATION NO. FOR LOfi7CE, BOARD, DEPABTMOM OB Imur TIrloN) SPEEDOMETER DATE FROM TO READING I O �E r a NATURE OF BUSINESS 4 POINT POINT START FINISH TRAVELED PER MILE 5 Y b 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 1853, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits and that no part of the same has been paid, Date �o� Uv1 PRESCRIBED BY STATE BOARD OF ACCOUNTS GEW"AL FORM NO. 10) 0"n MILEAGE CLAI (GOYERNNENrAL UNITt ON ACCOUNT OF APPROPRIATION NO. FOR tOFFICE, BOARD, Dr1ARTMDff OR [NSIXTUTION] FROM TO SPEEDOMETER AUTO AGE DATE READING POINT POINT START FINISH NATURE OF BUSINESS TRAVELED t PER MILE n non e s NA tnEn 5 IFC'o V7 1 WOW S 5 brls> b 2 Oil S 5-5 I o 51 4 O 1D ri Z F 8 S Ql� 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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits end that no part of the same has been paid. Date 300 qVA PMCRIBED BY STATL HOARD OF ACCOUNTS p GFNFRAL FORM IIO, 101 119863 MILEAGE CL TO (G0VERNMENTAL UNITI ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE. BOARD, DEPARTW32rr OR IMSnTU[IOM) SPEEDOMETER AUTO AGE DATE FROM TO READING t NATURE OF BUSINESS MILES POINT POINT START FINISH TRAVELED P WU CA 4 JS Mr) rn CLYA S EI 5.5 S tv10YL t n u Ail 1 Y1 T t., ,f s NAAnna S 1t VIn 22 S on 0 L 0 Is u ,5 E 1 Zg 5 5.5 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, I hereby Candy that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits eud that no part of the same has been paid. Date �f 00 LJ W Jot �y PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1905) MILEAGE CLAIM I To (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO- FOR (OF:ICE, BOARD, DEPAATW0WT OR INSTITUTION) SPEEDOMETER AUTO E FROM TO DATE I READING Zv q NATURE OF BUSINESS MILES s-LJ- POINT POINT STRR7 FINISH TAAVELED PER MILE C 22 6L o l� orl C 5 Mznon O o n o o r'c) o n b O In I M onon r AUTO LICENSE NO. TOTALS i 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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits end that no part of the same has been paid. Date LDOVI ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Payee Purchase Order No. 360484 Baldauf, Amy Terms 126 Lark Dr., Apt. D Date Due Carmel, IN 46032 }w Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4/30/10 Reimb Natl Afterschool Assoc. Conference 1 29.23 4/29/10 Reimb Club supplies from Hobby Lobby 67.48 4/30/10 Reimb Mileage 12/1/09 4/27/10 360.81 Total 557.52 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 1 20 Clerk- Treasurer i Voucher No. Warrant No. 360484 Baldauf, Amy Allowed 20 126 Lark Dr., Apt. D Carmel, IN 46032 In Sum of 557.52 ON ACCOUNT OF APPROPRIATION FOR j 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -99 reimb. 4343000 129.23 1 hereby certify that the attached invoice(s), or 1081 -8 reimb. 4239039 67.48 bill(s) is (are) true and correct and that the 1081 -8 reimb. 4343000 360.81 materials or services itemized thereon for which charge is made were ordered and received except rr l6 5 -May 2010 Signature 557.52 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund