HomeMy WebLinkAbout195887 03/29/2011 �w CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
1 ONE CIVIC SQUARE MEAGAN DECKER CHECK AMOUNT: $97.83
CARMEL, INDIANA 46032
CHECK NUMBER: 195887
CHECK DATE: 3/2912011
DEPARTMENT ACCOUNT PO NUMBER INVOIC NUMBER A DESCRIPTION
1081 4239039 REIMB 6.03 GENERAL PROGRAM SUPPL
1081 4343000 REIMB 91.80 TRAVEL FEES EXPENSE
Rarks&
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget D escriptio n Amount Purpose of Expense
L
2 2411 (fir= 7 Z3�d3`� c s��S �r S
2_, :57 o S`�e b�
All receipts should be attached in the same order as listed above.
[No sales tax w ill be reimburs TO TAL: r a
J
Employee Name (print) 1 Q-Lt O DQCVa' MAR
Check
Address 7�J�- Irk �Q f
payable to: City, St, Zip �a�i,L
Signature: Approved by:
Date: Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrativeWormslStaff Forms\Employee Exp Reimb Request
MARSH *17
7400 E. FISHERS STATION
FISHERS, IN 46030
(317)577-
3101 STA -FLO STARCH
'f 3.53 T 0M. Nigh? E�" iclac
TAX 25 BAL
3.78
14800 HAZELL DELL RD
MARSH SUPERMARKET #17 317 -844 -1004
7400 E. FISHERS STATION YOUR CASHIER WAS SELF CHECKOUT
FISHERS, IN 46038
(317 )577 -5325 KRD BREAD PC 1.25 F
Sc PLUS CARD SAVINGS 0.44
EFT DEBIT PURCHASE 02/24/11 12:09 PM Sc PLUS BREAD
SAVINGS 0.44 1 '25 F
damEqw TOTAL TRANSACTION 3 78 TAX
XAMOUNT KROGER PLUS CUSTOMER rtx *n
5319
BALANCE 0.00
REF:183517 2.50
x *�rxxxx
VF REF#: 000000
DEBIT PURCHASE: 2.50
CHANGE 3.00 t CASHBACK: 0,00
TOTFlL: 2.50
TOTAL NUMBER OF ITEMS SOLD 1
2124111 12:09 PM 0017 03 0005 115 2 .50
CHANGE 0.00
YOUR CASHIER WAS DENISE TOTAL NUMBER OF ITEMS SOLD 2
*"x *xxxxxx KROGER SAVINGS x *xitxxe
KROGER PLUS SAVINGS 0
TOTAL SAVINGS (26 Pct.) 0,88
T H AIVP1 YOU p� *xxxx* KROGER SAVINGS x *xx *xx�rx
'VK f OU FOR SHOPPING 03/04/11 01:37prr 980 81 52
MARSH
YOUR HOMEGROWN GROCER
SINCE 1931 Parch Fuel Pointe
Now Redeem Fuel Points at Kroger Fuel
Centers Participating Shells!
WE VALUE YOU Redeem 100pts to save .10 Per gal.
CHECK US OUT: http /Www.mbrsh,net Save up to $1 Per gal at Kroger OR
.10 Per sal at Shell on 1 fill -up.
Y
PRESCRIBED BY S741E BOARD OF ACCOUNTS GENF.AAL FORL uG. 1C1 (19861
MILEAGE CLAIM
TO
(GOVERNMENTAL UNI'L)
ON ACCOUNT OF APPROPRIATION NO- FOR
(Oii7CE, BOARD, DEPAR'e'M{]!'r OR lHbi'rtlfTIOR)
SPEEDOMETER
DATE FROM TO I READING NATURE OF BUSINESS AUTO I1I[
POINT POINT START FINISH TRAVELED
PER MILE
co- rn
�1M1
5( A l2 �n '7' f OY16 0 e 7 Yn C3D 7' D a o 7 7
b at1 y I 27
2. 2
I 3 7
o 7
e- v r l
c f`�
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no part of the same has been paid.
Date
r
-Y.�`
MAR 0 2011
C'
PRESCRIBED BY SrATC BOARD OF ACCOUNTS G"F,RAL FORM NC. ICI t1985y
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO FOR
(OF:7CB, 80AAD. DE4AATM37fr OA lN`ZTTITTION)
SPEEDOMETER
z DA FROM TO E READING AUT v A�E C
H NATURE OF BUSINESS POINT POINT START FINISH TRAVELED PER MILE
72
AUTO LICENSE NO. TOTALS I, �j D V n
f SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map C v
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
end that no part of the same has been paid.
Date
MA R 011
Y:...................
Carrel P Clay
P arks &Recreate ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
2-,370
She. S bra
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) -tow D2Cve�
Address
MAR 7 2011
Check
payable to: City, St, Zip od F
Signature7 Approved by: j
Date: jj r Date: �r 1
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrative \Forms�Staff FormslEmployee Exp Reimb Request
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.
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
3/4/11 Reimb Mileage 2/4 2/24/11 91.80
3/7/11 Reimb Program supplies 6.03
Total 97.83
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
Voucher No. Warrant No.
363382 Decker, Meagan Allowed 20
350 W Fall Creek Pkwy N Dr
Indianapolis, IN 46208
In Sum of
97.83
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #FFITILE AMOUNT Board Members
Dept
1081 -7 Reimb 4343000 91.80 1 hereby certify that the attached invoice(s), or
1081 -7 Reimb 4239039 6.03 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
24 -Mar 2011
J('.h &)mrU'n
Signature
97.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I