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HomeMy WebLinkAbout198737 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 00353077 Page 1 of 1 t, ONE CIVIC SQUARE DENNIS RUSS CARMEL, INDIANA 46032 C/O CARMEL WASTEWATER CHECK AMOUNT: $40.00 CARMEL IN 46032 CHECK NUMBER: 198737 CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 060711 40.00 OTHER EXPENSES t OF CA #A CITY OF CARMEL Expense Report (required for all travel expenses) _RIP, 2010 mileage reimbursement rate is 50 cents /mile EMPLOYEE NAME: Dennis Russ DEPARTURE DATE: na TIME: DEPARTMENT: Utilities /Sewer RETURN DATE: na TIME: REASON FOR TRAVEL: CDL renewal DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other 9 Breakfastj Lunch Dinner Snacks Per Diem 6/7/11 CDL renewal $40.00 $40.00 $0.00 $0.00' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0_.00 Total $0.00 $0.001 $0.00 $0.00 $0.001 $0.001 $0.001 $0.00 $0.00 $0.001 $40.00 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: City of Carmel Form ER06 Revision Date 6/7/2011 Page 1 Said YY-8ng gCtion INDIANA BUREAU OF MOTOR VEHICLES CARMEL 12955 OLD MERIDIAN S4603SUTrE 107 CARKEL- 317 846-5 08:59 AM 06/07"11 CARML10002 TERMINAL LAN RECEIPT q 3646802654 Aut, Code 045677 PAYMENT AMOUNT Pavment for Ref number g 40.00 Pavment a mount 0.00 Convenience Fee 40,00 Transaction Total I T3546802 D00040007 WWW.IN.GOV "BMV CUSTOMER COPY Bureau of Motor Vehicles Ii ff Customer Transaction Receipt I�IIOIIIII�III�I�IIIIIIIIII�III�I�I�I��II�III� q 1� State Form 51717 (4 -04) f Branch: CARMEL STARS (527) Date: 6/7/11 Time: 10:00:07 am EDT Visit ID: 166922906 Your Visit Time Today: Visit Customer: DENNIS M RUSS SR Wait Time 00:03:13 Transaction Time 00:04:14 Total time 00:07:27 Hrs.Min.Sec Transactions Trans ID Trans Type Trans Subtype Amount 192890291 Driver Renew CDL License Renew $40.00 192890769 Customer Amend Customer Amend $0.00 Subtotal: $40.00 Sales /Use 'Tax: $0.00 Total: $40.00 Payment Method Amou DL Number Authorization Number dame CREDIT $40.00 045677 Total Due: $40.00 Amount Paid: $40.00 Change Due: $0.00 Please help us improve our service by completing a one minute customer satisfaction survey. Your responses are completely confidential. Visit http: /www.in.gov /bmvsurvey /start and enter the survey code 166922906 to get started. Thank you. If you have questions or comments, please call our Customer Service Center at 888 -myBMV -411. Page 1 of 1 Il ll�ll lll�l illll 11111 111 I! lllil lull l�ll� lull ll�l� lull lllil lull llf 5 1 7 1 7 1 9 2 8 9 0 7 6 9 INTERIM /EXTENSION INDIANA CDL CLASS B W/ MC EXPIRES: 09/05/2011 R. Scott Waddell, Commissioner Valid only when presented with Previous Credential DATE: 06/07/2011°': DENNIS M RUSS SR %A p 18021 SANIBEL CIR SEX: M WESTFIELD, IN 46062730* HEIGHT: 5 -8 EYES: BLU RESTRICTIONS: NONE j;J WEIGHT: 190 HAIR: GRY ENDORSEMENTS: NM OPERATOR /BRANCH SSY /;�5, 7 Ci�RMEL STARS CONTROL NUMBER: 157TZ79'; SIGNATURE: d CUSTOMER COPY 5 RESTRICTIONS: NONE... ENDORSEMENTS: A CYCLE Ul ULK/CARGO TANK t a 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T9967 RUSS, DENNIS Purchase Order No. CARMEL WASTEWATER Terms Due Date 6/13/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/13/2011 060711 $40.00 I 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 Date Aker VOUCHER 115238 WARRANT ALLOWED T9967 IN SUM OF RUSS, DENNIS CARMEL WASTEWATER Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 060711 01- 7042 -06 $40.00 Voucher Total $40.00 Cost distribution ledger classification if claim paid under vehicle highway fund