HomeMy WebLinkAbout158427 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CHECK AMOUNT: $378.88
CARMEL, INDIANA 46032 1847 WELCHWOOD CR, APT 289
INDIANAPOLIS IN 46260 CHECK NUMBER: 158427
CHECK DATE: 4/1512008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A MOU NT D ESCRIPTION
1046 4343000 378.88 TRAVEL FEES EXPENSE
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r.
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
ILEAGE CLAIM
RE CEIVED TO c..:
(GOVERNMENTAL UNIT) A PR 4 2 008
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER AUTO MILEAGE
FROM TO READING
DATE NATURE OF BUSINESS MILES bo
19 d W- POINT POINT START FINISH TRAVELED PER MILE
C-
7-- t s m om.\ \r'3 W L- mo —\Ic- W C- `M
3-S C YY\ ar�ay. V�1 ►g
Mwtiw.- WC 16
ko r`(1C-1-1-1 lIS- l.q
3 t v.3 'M� wc.
3 n
�3 1 c� CSC
3 zo W L mer.or. V\fc-
3 Z' W C `y\ C-Y\O W� t
3 \NJ Q- rn o- wC t
j w C. w\ oy\ "vim
3 Crh WL 'N\OY\a- Wc- i
3 a� WC we 3z
AUTO LICENSE NO. TOTALS �s� c?5 O Q g
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, I 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
i
r
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF' certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
CD 0 In 0
p
Allowed 19_ M
W Pr W rt
f 0
in the sum of
a
M A b,
W 0 O
an
0
(Board or Commission) 0� W rt
a
FILED M
p
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(Official Title) O
H O ID
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 tv M
carmen 0ay
Parks& Recreation
Employee Expense Reimbursement Request
M A 2 5 2008
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
W l Imo tsis 0 00 Mya 13
3 I�aI$ G,o ,0 acQ,
31 1 31 9 S10 oes
31131 gro.�
SOSN
�A vq so
J\ VA lg MC. cclrs r\CL- a 1 Ct; �l� r we
All receipts should be attached in the same order as listed above. 22
No sales tax will be reimbursed. TOTAL: J
Employeen Name (print) ���`�1��� rG`Mrr\CY\S
Address C r
Check 1 Q
payable to: t
City, St, Zip �`na �^`r1G.{Jd�� y (A a u C
Signature: Vy Approved by:
Date: o� 4 Date:
Business Services Division, Revised 3 -2 -07
FILE: Shared\Administrative \Forms \Staff Forms \Employee 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.
Jennifer Hammons Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3128/08 Reimb Request mileage reimbursement 250.38
3/24/08 Reimb Request Travel for conference 128.50
Total 378,88
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.
Jennifer Hammons Allowed 20
In Sum of
378.88
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb Reg 4343000 378.88 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
14 -Apr 2008
Sig We
378.88 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I
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t
LuLu's Bait shack
17 S. Atlantic Bled 9212
FT Lauderdale, FL 33316
Server: Amanda 0311212008
Table 15/5 9:54 PM
Guests: 9 30092
Alllga %or Bites $.95
Blue Moon Draft 5.50
20oz Draft
SubTotal 14 45
Tax 0.54
Total 14.99
Ba 1 ance. F Ael 14 99
Debit may cause your
rank ^c'ds on your
funds for s::rrral days, lulus
is n:it for any
bank holds, fees, or extra
charges, that may accure
Lulu's Bait Shack
17 S. Atlantic Blvd 0212
FT Lauderdale, FL 33316
Server: Amanda DOB: 03/12/2008
09:59 PM 03/12/2008
Table 0/5 3/30092
5242990
Card
Magnetic card present: HAMMONS ,1FNNIFER L
Approval: 005833
Amount: 14.91
Tip: q!,
T ota i
X
J Customer Copy
,j c) i ri LA si en v e! i 1 E3 u ri cl zi sy
SI—OPI'-DY J0E ",3
()23 Table 41 NParty 'I
CHRISTINA 0 SvrCk 8 18:37 03/13/Ob
Separate checks I-of-3
2 PRES LITE 4.00
1 ISLAND KABOBS, I of each CID
own Total: 1E.95
fax: 0,76
30n '001: 17.73
Ob/13 190 11 FYN! 1 t 13
i- 1 e Psi F 1— l i c; t t i n
Flu)
Watch all the NFL games
in HO, MY at: SIOPPY jOe'S
with Direct TV and the NFL Ticket
18% GRATUITY WILL BE ADDED TO PARTIES
OF SIX OR MORE.
312
server: CHRISTINA D Rec:141
03/13/08 19:23, Swiped Terminal: 7
SLOPPY JOES /HOWL
17 S. Ft. Lauderdale Bch.
Blvd.
(954)522 -7553
MERCHANT
CARD TYPE ACCOUNT NUI4BER EXP
0210
Name: JENNIFER L HAMMONS
00 TRANSACTION APPROVED
AUTHORIZATION 082211
Reference: AU11921131
TRANS TYPE: Credit Card SALE
CHECK: 17.73
T I P --i�D
TOTAL-:
Y
PHONE: ***Dupl icate Copy
CARDHOLDER WILL PAY CARD ISSUER ABOVE
AMOUNT PURSUANT TO CARDHOLDER AGREEMENT
PLEASE SIGN 1 COPY AND KEEP THE 2ND
Bubba Gunp Shrin^ Ca
42� F*. Lauderdale Fea6
F1 LAUDERDALE, FL 33316
1- 954 463 -0777
Server: Victoria DOB: 03/14/2003
12:48 PM 03/14/1008
Table 4312 7/70015
314570
Card #
Magnetic dire orasent: RAM_MOMS JENNIFER L_
Approval: 014453
Anount: 5
Tip:
Total:
X
15% Gra ui y- ervice 41as Good
17% Grat it -Service 41as Great
20% Gratuity- Better Than Mon!
You can help Sea Turtles Inc.
by giving a $1. Sign below
X
x *xCUSTOMER COPY
Bubba Gump Shrimp Co
Restaurant Market
429 Ft. Lauderdale Beach
FT LAUDERDALE, FL 33315
1- 954- 463 -0777
Server: Victoria 03.114,/
Table 43/2 12:45
Guests: 1 70015
Mango Lada 7.95
no glass
,aptain's Fish n Chips 10.50
Items
total 18.45
1.12
19.57
Ance Due 19.57
Gratuity- Service Was Good
K.Gratuity- Service Was Great
M_ Gratuity- Better Than Mom!
,can help Sea Turtles Inc.
living a $1. Sign below
J•1ai�gari� <�Cantii�a
Crab and Seafood lloase
201 tS t Labii •beach Blvd
Ft.. L:auder�ialc Fl 131t.
,..914'.;i;.7 79.
e:�vEr Tracey I7(ll: t7.;/14j2 {1
07:51 PM 03*
Table 9.? _.'2062(
Card
iianneti� card. pre_;ent HAP'iMONS
iFNidf =R L
Aloproval': .085132::
Art un f ;.3 .92
Incl!ided Gratuity:
Additi Intz:l Graff
r^�
Total
r•or Convenience a,'15
grati y Etna been';iric_luded1.,!
Piea,se feel frae-; raise,.
lower or. re111D. -•e "this do ,at
vour discretion..
.Thank You
Merchant: loopy
Margarita Cantina
Crab and Seafood House
201 S [t Laud Deach 8lvd
Ft. Lauderdole, Fl 33316
p 954.463.7209
Server, 7racey 83/14/2O0�
Table 92/3 7:41 PM
Guests: 4 20024
Cams Lt (J @4.0O)
Steamed Shellfish
Cumplete Subtotal 32.00
Subtotal
Tax
Total 33.92
Gratuity 15.00% 4.80
Total 38.7-
ce Dm& '72-
For your Convenience a 151
gratuity has been included!
Please feel free to raise,
lower or remove this tip az
your discretion.
Thank You!
�RAVFL HO5PITALlTY S�RYlCF�
U� F t Loude rdd|�� I �n
�t8r�a�1&�
V�
Key NeSt T� *t
Sl ROSE
CHK 3 6 (l l MAR '5 08 538'
l C'gffae LG
l M M, 0 PPLE 1 OZ 2`
l Egg&Ha0 "J�
3ubtotul 7 O
Total Tnx
Tot al_Pa.id i� �Z�7�
S PRT} \3 03
C�d g8 Owed 1.7
NOW HTRING AL p��I. I�N
CALL 854-258-l50' EX 9 1 13ll\�
ENTER TO HIN A RIlE UP T8 050O�
-COMPLETE OUR 'GUEST S�RY5� AT
NMN.YOU�FEG��A C .TU/DNr
�NT[R�CO0E: 121804
IR�[ION DAT.il Jul 51Gt 2 8
i
CHASE DEO VOID N\
H H R
E' PROHI�I�ED np�N
�GAL RES OF CSA&CA�ADA
S z &'WN N .OURF�EDDACK TO/DHC
I CIO
CASH *4. 00
PM 1 Q cwf-.
Sr rtOnes= Narnetag Stuck, To order 8 00-233-9767.
SG A� ,)U AS$OO/4) JCPenney
O
P
gNNryEWO AftorschooI
JENNIFER
HAMM ®NS
CARMEL, IN
W -T -F
F I .11R,