HomeMy WebLinkAbout191610 11/10/2010 l
CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN DECKER
CHECK AMOUNT: $108.14
CARMEL, INDIANA 46032
CHECK NUMBER: 191610
CHECK DATE: 11/1012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1061 4239039 9.99 GENERAL PROGRAM SUPPL
1081 4343000 98.15 TRAVEL FEES EXPENSE
Carmel 0 Clay
Parks& Recreati ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Rece'spt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
She C�el2b�
All receipts should be attached in the same order as listed above..(
No sales tax will be reimbursed. TOTAL:
Employee Name (print) `DPc T Q
Address 11 lit'
a
Check
ble to:
payable city, st, Zip --Z/
signature: Approved by: I Date: C Date:
Business Services Division, Revised 7 -7 -08
FILE. Shared \Administrative\Forms\Staff Forms \Employee Exp Reimb Request
PRESC818CC/8Y STATE BOARD OF ACCOUNTS
c-TRAL FORM NO. 101 119161
MILEAGE CLAIM
To
1aoVERNHENTAL UNIT)
ON ACCOUNT OF APPROPRIATI O. FOR
tOFirCE, BOARD, VEPARTWDrr OR INSTMMON)
§PEEDOMETEA AUTO
DAT FROM TO �I READING MILES SAGE
to NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by lixed 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, niter alioA ing all just credits.-
and that no part of the same has been paid.
Date
NOV Q 3 2010
BY:
PRESCRIBED BY STATE HOARD OF ACCOUNTS GENERAL FORM IIC. X01 (1906)
MILEAGE CLAIM
To M�t�
!GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROP IDN NO FOR
(OFFICE, BOARD, DUARTUETi7 OR INSTITUTION)
W. SPEEDOMETER
FROM TO AUTO MILEAGE
DATE READING NATURE OF BUSINESS MILES CL 3
POINT POINT START FINISH TRAVELED PER WLE
V V1 &7 nrn l F
S 1 S clgoa
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 185, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits r
and that no part of the same has been paid.
Date rte`
V
0 3 X010 LOY
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
whore, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
363382 Decker, Meagan Terms
350 W Fall Creek Pkwy N Dr
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9.99
1018110 Reimb Site celebration
10126110 Reimb Mileage 1011 10/29/10
98.15
Total 108.14
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
Voucher No. Warrant No.
363382 Decker, Meagan Allowed 20
350 W Fall Creek Pkwy N Dr
Indianapolis, IN 46208
In Sum of
108.14
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1081 -7 Reimb 4239039 9.99 1 hereby certify that the attached invoice(s), or
1081 -7 Reimb 4343000 98.15 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
4 -Nov 2010
Signature
108.14 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund