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HomeMy WebLinkAbout193410 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 363874 Page 1 of 1 ONE CIVIC SQUARE. DEBORAH EGGER7 CARMEL, INDIANA 46032 1824 WHITE ASH DRIVE CHECK AMOUNT: $150.00 CARMEL IN 46033 ory CHECK NUMBER: 193410 CHECK DATE: 1/5/2011 DEPARTMENT ACCOUNT PO NUMB INVO NU MBE R AMOUNT DESCRIPTION 1207 4239040 12110 150.00 TIPS Brookshire Golf Club Carmel, Indiana Substitute Form 4070A Employee's Daily Record of Tips Erg �ployee Name (please print) C C Payroll Day Date Total Tips Received Saturday IS O Sunday Monday Tuesday Wednesday Thursday Friday j Total Weekly Tips Substitute Form 4070 Employee's Report of Tips to Employer E -m la ee's Name and Address Employee's Social Security Number i c Cash Tips Received from record above E Employer's Name and Address Period for which tips were received City of Carmel From (date) One Civic Square Carmel, IN 46032 To (date) i =mp yee Signature Date VOUCHER NO. WARRANT NO. ALLOWED 20 Debbie Eggert IN SUM OF 1824 White Ash Drive Carmel, IN 46033 $150.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 DEggertl2 /11/10 42- 390.40 $150.00 1 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 Monday, December 27, 2010 Director, Brooks re Golf Club 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)) 12/11/10 DEggertl2 /11110 Tip $150.00 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 20 Clerk- Treasurer