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HomeMy WebLinkAbout189819 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 00350224 Page 1 of 1 ONE CIVIC SQUARE NANCY HECK CARMEL, INDIANA 46032 CHECK AMOUNT: $1,272.45 CHECK NUMBER: 189819 CHECK DATE: 9/14/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 4342100 12.45 POSTAGE 1160 4343001 105.00 TRAVEL FEES EXPENSE 1160 4343003 930.00 TRAVEL LODGING 1160 4343004 225.00 TRAVEL PER DIEMS CITY OF CARMEL Expense Report (required for all travel expenses) ,NOIANP. EXHIBIT A EMPLOYEE NAME: DEPARTURE DATE: 7 TIME: AM/PM DEPARTMENT: z RETURN DATE: �f'd'cu f' TIME: AM PM REASON FOR TRAVEL: 5CMA- DESTINATION CITY. EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Misc. Total T' 4xi— Tips Luggage Parking Breakfast Lunch Dinner Snacks Per Diem sz, 6 aP oc ri ya h 4yy Ve t Sh' <.L IT 12. [q -lo 311: 0 .SW moo:: 2 _9 6'S`ov -4 Total 1 4 1 30.0d Db End DIRECT'OR'S STATEMENT: thereby ffirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: r Date: City of Carmel Form ER06 Revision Date 9/25/2008 Page 1 For advance payments, claim form must be submitted ten (10) business days in advance of travel. Claim will not be processed without the following documentation: 1) Conference or course registration form, if applicable 2) Travel itinerary or car rental agreement, if applicable 3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt) Prorated meal allowance: For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in -state travel and for out -of -state trave For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in -state travel and 30 for outof:_state travel For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in -state travel and $30 for out -of -state travel For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in -state travel and $65 for out -of -state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: hereby acknowledge receipt of such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen. understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to: 1) Submit original itemized receipts to the office of the Clerk- Treasurer documenting all meal expenditures; and 2) Return all unused funds to the office of the Clerk- Treasurer I further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: City of Carmel Form ER06 Revision Date 9125/2008 Page 2 RECEI I f; AV EL RECEIPT N01 VALID F NOT VALID FOR TRAVEL MARTA MARTA j Y Airport Tvm"iolll TVM20708 Wed 08 Sep .10 0 3 56PM Tue 07 Sep 10 05:50PM l i VISA Pal payment Type: VISA Pil pass Purchase: Round Trip i ol la Ci I- i 2 Quantity: 2 %J 25.00 Atito If' Amount.; 9.00 j3j C I-d Breeze Card 4369 3526 Credit Card 00 Auth 00716B ALIL11 _,()FNP4_JM8 VT5UE4MPVX9G Ref T! ioit ()()002202' Ref :4 Tra Transaction 4:0000074823 �*41;a Awae4 A i rt ran Payment Receipt e-" n7dti De 74U j?4.V (404) 872-2600 (404) USE -TAXI Date loseplo (404) 371-4535 (404) 873-8294 Confirmation Number PFRJYH Taxi Service Receipt Receipt /Ruth PFRJYH Received JIM 30.00 Cab #/_Z Date 30.00 USD From: $30.00 $30.00 USD To: Remarks XXXXXXXXXXXA► Driver: Received by Agent 100963 Fare, Signature: Tips, Total, Welcome to Kwik Kopy Business Center �;tore:224A Clerk:73 Register :1. 09/10/2010 10:07:50 Transaction##: 31718 Fragile Wrap /Fill Por 12s12xl2 1@ 2.45 2.45 Sar•,a.ces 10@ 1.00 10.00 Sub Total: 12.45 Standard: Exempt Balance Due: 12.45 CCard: 12.45 Change: 0.00 Thank You for Shopping With Us. Please Come Again tl IIOb.GUN011NYd1my -w Yqn wM an!'mLN9bW Ctl mfPV�am�dOWmiG6� '�aa�uuadRwnwYB bemdm�b w PNC Online Banking Page 2 of 3 Account Activity Sign On to Card S Everyday Rewards XXXXXXXXXXXXM Balance: Minimum Payment Due: Payment Due Date: t Balance: Cash Advance Balance: ffift Available Credit: 0 Available for Cash Advance: INEMOMMI Credit Umit: Cash Advance APR: Next Statement Date: 09/17/2010 Purchase APR: Last Statement Balance: Last Payment: Posted Transactions List By Date Search Statement: Current Export Date DoscripVon Amount 09/10/2010 AIRTRANAIR 3320093475075 01047170500047 ATLANTA GA $30.00 Ism i END 0910812010 MARTA ATLANTA 00000018 01041640700043 ATLANTA GA $25.00 l 09/072010 MARTA ATLANTA 00000018 01041640700043 ATLANTA GA $9.00 09/07/2010 AIRTRANAIR 3320093295769 01047170500047 ATLANTA GA $30.00 https:// www. onlinebanking. pne. com/ alservlet /CreditCardActivityServlet ?account= ////3200... 9/131/2010, 1216 Nancy Heck 1 140.00 City County Communications 1 1326 Cool Creek Drive 193430 EX -A Carmel, IN 46033 1 07- SEP -10 18:41 10- SEP -10 CCC910 VI 07- SEP -10 RT1216 Room Revenue 155.00 08- SEP -10 RT1216 Room Revenue 155.00 08- SEP -10 jh Postage 0.88 09- SEP -10 RT1216 Room Revenue 155.00 SEP -10 465.88- fs8 d• �o5i+� Balance Due .00 For your convenience, this is a zero balance folio indicating a $0 balance on your account. Please be advised that any charges not reflected on this folio will be charged to the credit card on file. While this folio reflects a $0, balance, you may not be charged until after you depart. You are ultimately responsible for paying all of your charges. No need to stop by the welcome Desk, simply check out print your boarding pass via the Farewell Kiosk located by the lifts! EXPENSE REPORT SUMMARY Date Room Tax Food Bev Telecom Laundry Other Total Payment 07- SEP -10 155.00 0.00 0.00 0.00 0.00 155.00 0.00 08- SEP -10 155.00 0.00 0.00 0.00 0.88 155.88 0.00 09- SEP -10 155.00 0.00 0.00 0.00 0.00 155.00 0.00 Total 465.00 0.00 0.00 0.00 0.88 465.88 0.00 Were all your wishes granted? Just let me know. GMWAtlanta.Midtown @whotels.com. Explore a world of Wonder 24/7/365 As a Starwood Preferred Guest, you could have earned 600 Starpoints for this visit. Please provide your member number or enroll today. Nancy Heck FOLIO 193430 07- SEP -10 1218 Melanie Lentz 140.00 City County Communications 1 1326 Cool Creek Drive 193431 EX -A Carmel, IN 46033 1 07- SEP -10 18:43 10- SEP -10 CCC910 VI 07- SEP -10 RT1218 Room Revenue 155.00 08- SEP -10 RT1218 Room Revenue 155.00 09- SEP -10 RT1218 Room Revenue 155.00 10- SEP -10 465.00 Balance Due 0.00 For your convenience, this is a zero balance folio indicating a $0 balance on your account. Please be advised that any charges not reflected on this folio will be charged to the credit card on file. While this folio reflects a $0, balance, you may not be charged until after you depart. You are ultimately responsible for paying all of your charges. No need to stop by the Welcome Desk, simply check out print your boarding pass via the Farewell Kiosk located by the lifts! EXPENSE REPORT SUMMARY Date Room Tax Food Bev Telecom Laundry Other Total Payment 07- SEP -10 155.00 0.00 0.00 0.00 0.00 155.00 0.00 08- SEP -10 155.00 0.00 0.00 0.00 0.00 155.00 0.00 09- SEP -10 155.00 0.00 0.00 0.00 0.00 155.00 0.00 Total 465.00 0.00 0.00 0.00 0.00 465.00 0.00 were all your wishes granted? Just let me know. GMWAtlanta.Midtown @whotels.com. Explore a world of Wonder 24/7/365 As a Starwood Preferred Guest, you could have earned 600 Starpoints for this visit. Please provide your member number or enroll today. Melanie Lentz FOLIO 193431 07- SEP -10 ,AirTran Airways Reservations Page 1 of 2 receipt itinerary Thank you for choosing AirTran Airways. We will send you an email message containing your itinerary. To ensure you receive the message, you may wish to add confirmations @airtran.com to your address book. confirmation number: PFRJYH Booking date: Tue, Jun 08, 2010 Status: Confirmed Should our flight schedule change, we will notify you by email as early as possible. Flight Details Departing: Tuesday, September 07, 2010 Indianapolis, IN (IND) to Atlanta, GA (ATL) Flight 429 Coach 3:47 PM 5:18 PM Returning: Friday, September 10, 2010 Atlanta, GA (ATL) to Indianapolis, IN (IND) Flight 415 Coach 3:00 PM 4:35 PM Passengers and Seat Assignments Passenger A+ Number IND -ATL ATL -IND Nancy Sue Heck 601 1 0=11110 19E DOB: added Melanie Jo Lentz Add A+ Number 19F DOB: added Contact Information Nancy Heck nhecklaw@aol.com 1326 Cool Creek Dr. 317 848 -4840 (Tel) Carmel, IN 46033 317-431 -5393 (Alt) United States of America Pricing Payments Total for 2 passengers detail) Payment via Credit Card Fare price: $238.14 Form of payment: Taxes /fees: $60.66 Payment status: Confirmed Seat fees: $12.00 Payment amount: $310.80 Total price: $310.80 Terms and Conditions Fare Restrictions https: /tickets. airtran,com/Printjtinerary. aspx 9/6/2010 AirTran Airways Reservations Page 2 of 2 Coach H Fare Class Coach Class Non refundable Changes may be made for a fee of $75 per person plus any applicable increase in fare. Advance seat assignment is available for a small fee, or you may select your seats upon check -in at no cost. Reservations may be obtained or changed through an AirTran Airways Telephone Reservations Center for an additional $15.00 per person. Additional baggage fees may apply. Coach R Fare Class o Coach Class Fare Non refundable Changes may be made for a fee of $75 per person plus any applicable increase in fare. Advance seat assignment is available for a small fee, or you may select your seats upon check -in at no cost. Reservations may be obtained or changed through an AirTran Airways Telephone Reservations Center for an additional $15.00 per person. Additional baggage fees may apply. Conditions of Contract: All AirTran Airways coach tickets are non refundable and a $75 fee per person applies to any change made after purchase, plus any applicable increase in airfare. Business class tickets (A and J fare classes only; not including promotional fares) are fully refundable and no fee applies to changes. Cancellations must be made at least one hour prior to departure or customer forfeits reservation and any monies paid against the reservation. This reservation is non transferable no name changes allowed. Baggage Policies: Familiarize yourself with our baggage policies prior to your travel. Ticket Counter Check -In Requirements AirTran Airways recommends that passengers arrive at the airport 120 minutes prior to the scheduled departure of their flight. Due to security requirements, passengers and their baggage will not be accepted at the ticket counter less than 45 minutes prior to the scheduled departure of their flight (some smaller airports may accept baggage up to 30 minutes prior to scheduled departure time). Gate Check -In Requirements Customers must present themselves at the flight departure gate no later than ten minutes prior to the scheduled departure of their flight. Failure to comply will cause the customer to lose their reservation and, if so, they will not be eligible for denied boarding compensation. Destinations Visit our Travel Info section to learn more about travel to https a/ti ckets. ai rtran. com[.Printltinerary. aspx 9/6/2Q 10 .3CMA Official Website Page 1 of 1 €x C ITY C OUNTY COMMUNICATIONS M search our site... C C] MARKETING AssocIATION STRATEGIC MARKETING. COMPELLING COMMUNICATIONS. NO 4 x �,i. ro You are here- tiome Forms Savvy Awards 2010 Annual Conference Early Registration 2010 Annual Conference First Name' Nancy 3CMA Officers last Name' Heck Online Services Title Director of Community Relations Jurisdiction City of Carmel Notify Me Street Address One Civic Square City' Cannel State' Indiana 9P' 460a2 SUBMIT ONLINE PIiO10 317- 571 -2474 PAYMENT Fax 317- 571 -2278 E Mall' nheck@carmel,in.gov CONFERENCES Pre-Conference Members: $98 Hon- Members: $125 FORUM Regular Conference' 'r tay rg Members 5 I at Conference Hotel or Local Members: Non Members Staying at Conference Hotel or Local Attendee: $635 l Members Not Staying at Conference Hotel: $630 Non- Members Not Staying at Conference Hotel: $735 MEMBER LOGIN Payment Options Payment may be made by check payable to 3CMA or on-ine by credit card, The link for the on -line credit card option can be found on the confirmation page. Cancetlatlon Policy Requests for canceltations or substitutions must be made in writing (no fax or e-mail, please). Cancellations between August 23, 2010 and August 27, 2010 will be subject to a S75 administrative fee. After August 27, 2010, no refunds will be processed for cancellation. Substitutions may be made at anytime in writing. Telephone substitutions and cancellations will not be accepted. Note: It payment is made on-line via credit card though PayP81 and a refund is requested 60 days or more after initial payment, the refund issued will be minus the 2.9% fee that 3CMA is charged. indicaies required fields. Submit R Cancel noun I contact es Prat page I emWl page I accesslbllny I rss' I Powered by Crvitphee J Copyright Notices http:/ /www.3cma.org/Forms.aspx ?FID =92 5/14/2010 3CMA Official Website Confirmation Page Page 1 of 1 `K e 1 r 'a CITY--COUNTY COMMUNICATIONS: search our site... GC MARKETING ASSOCIATION STRATEGIC MARKETIN-G. COMPELLING COMMUNICATIONS. am You are here: Home Meetings and Conferences Annual Conference Confirmation Page Preliminary Conference Schedule Thank You For Your Registration Conference Hotel Thank you for registering for 3CMA's 2010 Annual Conference in Atlanta, GA September 8 10, 2010. We look forward to seeing you in Septemberl Conference Registration Information Payment Options Payment can be made online via credit card or by sending a check or money order to: Sponsorship Information 3CMA PO Box 20278 Annual Conference Washington Duties International Airport Facebook Page Washington, DC 20041 Please contact 3CMA with any questions or concerns that you may have by calling (703) 707 -0830 or by a -mail. SUBMIT ONLINE PAYMENT Cancellation Policy Requests for cancellations or substitutions must be made in writing (no fax or e-mail, please). Cancellations between i a August 23, 2010 and August 27, 2010 will be subject to a $75 administrative fee. After August 27, 2010, no refunds will be j CONFERENCES processed for cancellation. Substitutions may be made at anytime in writing. Telephone substitutions and cancellations will not be accepted. Note: If payment is made on -line via credit card though PayPal and a refund is requested 60 days or more after initial FORUM /o payment, the refund issued will be minus the 2.9 fee that 3CMA is charged. Q MEMBER LOGIN home I contact us I print page I email page I accessibility rssr." I Powered by ClvicP]us I Copyright Notices http://www.3cma.org/index.aspx?NID=362 5/14/2010 3CMA Official Website Preliminary Conterence Schedule Page 1 of 1 r CITY-COUNTY COMMUNICATIONS. sear[hourslte... GO MARKETING P'rSSOCIATION STRATEGIC MA,RK•ETING. COMPELLING COMMUNICATION'S. .s"+de �4 '�T: a :kFa k a1 �t x� r I' d ��w:. mu �.,•rP�' x Y You are here: Home Meatinas and Conferences Annual Conference Preliminary Conference Schedule Preliminary Conference Schedule Preliminary Annual Conference Schedule Conference Hotel Note: Session times and subjects are subject to change. Conference Registration Wednesday September 8, 2010 Information Pre Conference 8:00 a.m. Pre- Conference Registration Sponsorship Information 9:00 a.m. Pre Conference Sessions Begin Annual Conference 11:30 a.m. Pre- Conference Luncheon Facebook Page General Conference 11:00 a.m. General Conference Registration Begins i SUBMIT ONLINE PAYMENT 12 :15 p.m. Gathering for First Timers 1:00 p.m. Opening Session ,.r 2:00 p.m. Concurrent Sessions CONFERENCES 3:15 p.m. Networking Break 3:45 p.m. Concurrent Sessions 1 5:30 p.m. Welcome Reception FORUM 6:30 p.m. Restaurant Ramp MEMBER Thursday September 9, 2010 S LOGIN 7:30 a.m. Continental Breakfast 9:00 a.m. Concurrent Sessions 10:15 a.m. Networking Break 10:45 a.m. General Session 12 Noon Savvy Awards Presentation Luncheon 2:00 p.m. Concurrent Sessions 3:15 P.M. Networking Break 3:45 p.m. Concurrent Sessions 4:30 p.m. 3CMA Board of Directors Meeting Evening Discover Atlanta (on your own) Friday September 10, 2010 7:30 a.m. Continental Breakfast 8:00 a.m. 3CMA Business Meeting 9:00 a.m. Concurrent Sessions 10:15 a.m. Networking Break 10:45 a.m. Concurrent Sessions 12 Noon General Conference Adjourns Lunch is on your own 2:00 p.m. Optional Networking Sessions home I contact us I print page I email page accesslbllity MC I Powered by ClvicPlus Copyright Notices http /www.3cma.org/index.aspx ?NID =366 5/14/2010 3CMA 22 Annual Conference Attendance List (as of September 1, 2010) Larry Allen Michelle Bono Gloria David Sarasota County, FL City of Tallahassee, FL City of Bismarck, ND Steve Allen Mark Boyer Judy Davidson City of Charlotte Neighborhood New Hanover County, NC Buncombe County, NC Business Svcs, NC Julie Brechbill Pam Davis Mark Andrews City of Roswell, GA City of Kennesaw, GA Town of Holly Springs, NC Nicolette Brennan Tracy Dawson Saja Aures City of Cape Girardeau, MO New Hanover County, NC City of Savannah, GA Krystal Britton Kevin Dean Ann Bane City of Hinesvi ►le, GA City of Grand Forks, ND City of Hampton Public School, VA Corky Brown Lynne DeWilde City of Cedar Hill, TX City of Suwanee, GA Susan Banks City of Lake Forest, IL Jon Brown Bill Doughty, APR Leon County, FL CH2M Hill, CO Jim Barnes Loudoun County, VA Erin Bryce Trina Duerksen City of North Port, FL Sandy City, UT Denise Barrett City of Weston, FL Tom Bryson Christy Edwards City of Farmers Branch, TX City of Asheville, NC Ric Barrick City of Charlottesville, VA Leslie Buckiin Ann Erdman Los Alamos County, NM City of Pasadena, CA Katie Barron City of Sierra Vista, AZ Amber Callahan Kristi Estes City of Hampton, VA CIG, CO Diane Baxter City of The Colony, TX Carrie Camden Stacey Ewell City of Statesboro, GA City of Germantown, TN Katie Beal City of Eden Prairie, MN Joanna Carabello Justin Finestone Athens Clarke County, GA City of Bend, OR Bill Behenna City of Tallahassee, FL Susan Cerbone Tammy Flynn City of Daytona Beach, FL City of Hampton, VA Bret Bell City of Savannah, GA Laura Cleland Mona Gandy Association of Oregon Counties, City of Colleyville, TX Kim Bergeron OR City of Slidell, LA Lyn Garris Lori Crowe City of Rock Hill, SC Sara Berry Norfolk Public Library, VA City of Maryland Heights, MO Randy Gehl Anne Curtis City of Dubuque, ►A Dave Bigos Town of Herndon, VA City of Chandler, AZ Kathy Gilwit Matthew Daily City of New Rochelle, NY Terry Bishirjian City of Marietta, GA City of Norfolk, VA Mike Gin Edie Damann City of Redondo Beach, CA Becky Blue City of Dunwoody, GA City of Wilmington, NC Shannon Gowan Michelle D'Antoni City of Temple, TX Rebecca Bohlander Town of Holly Springs, NC City of Cartersville, GA Andrew Graham MARC, MO 1 3CMA 22 "d Annual Conference Attendance List (as of September 1, 2010) Janna Patrick Nicole Scheider Rosemary Taylor City of Conroe, TX Flood Control Dist. of Maricopa City of Johns Creek, GA Co., AZ Anthony Perrone Beverly Thompson Buncombe County, NC Shelly Schulz City of Durham, NC City of Mankato Mankato Area Mandy Pitts Public Schools, MN Jill Thompson City of Hickory, NC City of Lincoln, CA Mark Scott Joni Powell City of Fresno, CA Robert Tucker Town of Holly Springs, NC Johnson County, KS Mary Scott Annette Privette Keller City of Colorado Springs, CO Kevin Tunell Town of Matthews, NC Yuma County, AZ Deanna Sheely Michele Quander Collins Xcel Energy, MN Sandi Turner Fairfax, VA Athens Clarke County, GA Laura Shepard Katie Quinn City of Gresham, OR Jeremy Twiggs City of Rock Hill, SC Buncombe County, NC Preeti Shridhar Andrea Rasizer City of Renton, WA Michelle Van Dyke Arapahoe County, CO Hillsborough Co. Water Pier Simed Resource Services, FL Frank Reed City of Avondale, AZ Tualatin Valley Water Dist., OR Jane Volz Karla Slate Los Alamos County, NM Sean Reilly City of Covington, WA City of Overland Park, KS Beth von Behren Julie Smith City of Kirkwood, MO Joe Rice City of Colorado Springs, CO City of Charlottesville, VA Patrick von Keyserling Gina Snider City of Boulder, CO Mary Robertson City of Newnan, GA City of St. Joseph, MO Joan Walls Jay Socof City of Champaign, IL Cindy Rodriguez City of College Station, TX Polk County, FL Anne Whipple Candace Sountris City of Lake Forest, IL Nannette Rodriguez City of Moline, IL City of Miami Beach, FL Ashleigh Whiteman Heidi Stark City of Hurst, TX Louise Romero City of McKinney, TX Los Alamos County, NM Alisa Williams Evelyn Sterling City of Duluth, GA Debbie Russell Village of Park Forest, IL City of Hampton, VA Van Williams Keith Sterling City of Wichita, KS Lori Sand City of Burbank, CA Johnson County Wastewater, Steve Wright KS Kathleen Stewart City of Mesa, AZ Frisco Economic Dev. Corp., TX Abby Sandel Nikki Young City of Hyattsville, MDMD Shaunieka Taste Hall County, GA Gwinnett County, GA 3 VO UCHER N O. WARRANT NO. -r ALLOWED 20 Nanvy Heck IN SUM OF 1326 Cool Creek Drive Carmel, IN 46033 $1,272.45 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO# Dept. INVOICE NO, ACCT /TITLE AMOUNT Board Members 1160 Expense Report 43-421.00 $12.45 1 hereby certify that the attached invoice(s), or 1160 Expense Report 43- 430.03 $930.00 bill(s) is (are) true and correct and that the 1160 Expense Report 43- 430.01 $105.00 materials or services itemized thereon for 1160 Expense Report 43- 430.04 $225.00 which charge is made were ordered and received except Monday, September 13, 2010 t, Mayor Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/13/10 Expense Report $12.45 09/13/10 Expense Report $930.00 09/13/10 Expense Report $105.00 09113/10 Expense Report $225.00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance wi:h IC 5- 11- 10 -1.6 20 Clerk- Treasurer