HomeMy WebLinkAbout157160 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 00353070 Page 1 of 1
c f ONE CIVIC SQUARE DAVID MCCOY
CARMEL, INDIANA 46032 cio CHECK AMOUNT: $92.25
9 c/o is
CHECK NUMBER: 157160
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 92.25 EXTERNAL TRAINING TRA
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM 1 M CC O
TO DAV
I ((3OVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING
le 2 toD l POINT POINT START FINISH NATURE OF BUSINESS T AVE ED PER MILE
AIJ v t c is l7 iV 'j 1V08 i f S V i U F- CITY N✓+ l L J /mot Ill 6 i
J 3 N� LE3v' C( N R LL PbLltE PE4>—, I
P OLICE T 44M Cut Co i+) 5Tn(? 1 b C C ARr"W tr •T j cw' l
A' 3 1 NAM LTUN co ,DRIGLC0 ~f PQ I CT
Q i i',n4 z- ft TT L w ti r!J Q `f Aj Omp 6i5 n w PEP Nc l-
t,uD �r 1 i
3 10 mDkf
AUTO LICENSE NO. TOTALS �f
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
and that no part of the same has been paid.
Date L'
ZI
i
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
'j— by law
That it is based upon statutory authority.
correct
That it is apparently incorrect
1 -17
On Account of A Disbursing Officer
ppropriation No. for
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 0
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CITY OF CARMEL Expense Report (required for all travel expenses)
�✓OIANp
EMPLOYEE NAME: 1 >�F Me �"y Y DEPARTURE DATE: Z`1 �j 2- TIME: 7 A PM
DEPARTMENT: s RETURN DATE: 2 -I 7--7- TIME: (o: D D AM P
REASON FOR TRAVEL: G CS 6DN FE 9 F_NC C DESTINATION CITY: N M,nJA O L f S
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. "Total'
Parkin
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
2/19/08 $12.00 $20.78 $32.78
2/20/08 $12.00 $12.00
::;;$0:00
$0.00
$0:00
$0.00
$0.00
„$0,00
$0.00
Y$0.00
$0:00
$0.00
$0.00
$0.00
'"Moo
$0.00
$0.00
$0.00
F_ 0.00
Total $0:00 $0.00 $0:00, $24:00 $0:00 $0.00 $20.78 '$0.00 $0.00 $0.00 $0:00
DIRECTOR'S STATEMENT: I ereby affirm that all expenses listed conform to the City's travel policy and are within I my department's appropriated budget.
Director Signature: Date: O
City of Carmel Form e06 Revision Date 2/21/2008 Page 1
For advance payments, claim form must be submitted ten (10) business days in advance of travel.
Claim will not be processed without the following documentation:
1) Conference or course registration form, if applicable
2) Travel itinerary or car rental agreement, if applicable
3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt)
Prorated meal allowance:
For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in -state travel and $60 for out -of -state travel
For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in -state travel and $30 for out -of -state travel
For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in -state travel and $30 for out -of -state travel
For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in -state travel and $60 for out -of -state travel
EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES:
I hereby acknowledge receipt of such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals
while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen.
I understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to:
1) Submit original itemized receipts to the office of the Clerk- Treasurer documenting all meal expenditures; and
2) Return all unused funds to the office of the Clerk- Treasurer
I further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first
paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total
advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return.
Employee Signature: Date: 2--Z -o
City of Carmel Form ERO6 Revision Date 2/21/2008 Page 2
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Table 508/,',' 1:03 PM Server: Cae DOB: 02/19/2008 M M n
Guests: 3 0 1 1
6001 01:11 PM 02/19/2008
Order Type: ORDER Table 508/3 6/60010
Seat 3
Magnetic card present: Or ZS W
Ice tea 2.20' w 2)
Approval: 019523 4 A Q
Fish and Chips 12.99 00
S- Pub Chips F
Irish Sour Cream 1.00 Amount: 17.54
a n rt 7
16.24 67 t
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Tax 1.30
Total 17.54
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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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
bavid McCoy Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02121 ins Milea e $47.47
Total
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.
20
Clerk- Treasurer
VOUCHER Ug /_WARRANT NO.
aVl C py ALLOWED 20
IN SUM OF
$92.25
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1202 Informatin Systems
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1202 430-02 8 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
430 -02 $47.47 which charge is made were ordered and
received except
20
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3
Sitt e r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund