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