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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