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)
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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
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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