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HomeMy WebLinkAbout202407 10/05/2011 CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1 ONE CIVIC SQUARE MIKE MCBRIDE CHECK AMOUNT: $1,483.91 CARMEL, INDIANA 46032 C/O ENGINEERING C!0 ENGINEERING CHECK NUMBER: 202407 CHECK DATE: 10!512011 DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION 2200 4343002 1,354.04 DENVER /DALLAS 2200 4343002 129.87 MILEAGE 4 S y OF CA CITY OF CARMEL Expense Report (required for all travel expenses) EXHIBIT A EMPLOYEE NAME: Mike McBride DEPARTURE DATE: I TIME: V. !!Z M PM DEPARTMENT: _Engineering RETURN DATE: TIME: •.�J M PM REASON FOR TRAVEL: TE APWA Conference DESTINATION CITY: Deaver CO to Dallas /Garland TX EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM _X_ Date Trans ortation Gas/Toll Lodging Meals Misc. Total Air -fare Car Other s/ Breakfa Lunch Dinner Snacks er 9114/11 $76.00 $758.04 W 520.00 _t $1,354.04 9/21/11 L' $0.00 $0.00 $0.00 r $0.00 I g $0.00 f $0.00 (z0 $0.00 $0.00 $0.0© $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 $76.00 $0.00 $758.04 $0.00 $0.00 $0.00 $0.00 $520.00 $0.00 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. City of Carmel Form 9 ER06 Revision Date 10/4/2011 Page 1 Director Signature: Date: 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 $65 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 $32.50 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 $32.50 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 $65 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. 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: oz' City of Carmel Form ERO6 Revision Date 1014!2011 Page 2 C� 1420 Stout Street Denver, CO 80202 Phone (303) 592 -1000 Fax(303)592-1001. E M n ASS v 5 11 IT FS' For reservations across the nation Name Address Denver Downtown Cnnvenion Center www.enbassysuites.com or 1- 800- EMBASSY(D MCBRIDE, MICHAEL Suite 1128/TQVN 1275 K STREET NW STE 750 Arrival Date 9/17/2011 7:31:OOP Departure Date 9/21/2011 WASHINGTON, DC 20005 US Adult /Child 2/0 Room Rate 165.00 RATE PLAN C-PBW HH# AL: BONUS AL: CAR: CONFIRMATION NUMBER: 80946581 912112011 PAGE 1 DATE REFERENCE DESCRIPTION AMOUNT 9/17/2011 256840 GUEST ROOM $165.00 9/17/2011 256840 STATE SALES TAX $6.77 9/17/2011 256840 CITY LODGING TAX $17.74 9/18/2011 257752 GUEST ROOM $165.00 9/18/2011 257752 STATE SALES TAX $6.77 9/18/2011 257752 CITY LODGING TAX $17.74 9/1912011 258635 GUEST ROOM $165.00 9/19/2011 258635 STATE SALES TAX $6.77 9/19/2011 258635 CITY LODGING TAX $17.74 9/20/2011 259555 GUEST ROOM $165.00 9/20/2011 259555 STATE SALES TAX $6.77 9/20/2011 259555 CITY LODGING TAX $17.74 WILL BE SETTLED TO $758.04 EFFECTIVE BALANCE OF $0.00 EXPENSE REPORT SUMMARY _K 1 00:00:0D1 12:00:OOAM 011 12:00:OOAM11 12:00:OOAM SAY TOTAL ROOM TAX $189.51 $189.51 $189.51 $189.51 $758.04 DAILY T TAL $189.51 $189.51 $189.51 $189.51 $758.04 EXPRESS CHECK -OUT DATE OF CHARGE FOLIO NO.ICIIECK NO. Good Morning We hope you enjoyed your stay. With Express Check -Out AUTHORIZATION 68526 ITIAL there is no need to stop at the Front Desk to check out. Please review this statement. It is a record of your charges as of late last evening. PURCHASES SERVICES For any charges after your account was prepared, you may. pay at the time of purchase. TAxe,S charge purchases to your account, then stop by the Front Desk for an updated statement. or request an updated statement be mailed to you within two business days. TIPS MISC. Simply call the Front Desk from your room and tell us when you are ready to depart. Your account will be automatically checked out and you may use this TOTAL AMOUNT statement as your receipt. Feel free to leave your key(s) in the room. 0.00 Please call the Front Desk if you wish to extend your stay or if you have any questions about your account. PAYMENT DUE UPON RECEIPT- 1.5% PER MONTH INTEREST CHARGE, WILL RE APPLIED TO ALL PAST DUE INVOICES. From: APWA 2011 International Public Works Congress and Exposition mailto: eve ntconfirmation @xpressreg.net] Sent: Tuesday, July 05, 20116:59 PM To: McBride, Mike T Subject: APWA 2011 International Public Works Congress and Exposition Registration Confirmation Important Show Information I Dear Michael McBride, hank you for registering for APWA's 2011 International Public Works Congress Exposition! Please note that your registration payment has been secured by a PURCHASE ORDER. PLEASE FAX THE PURCHASE ORDER TO 508 -743 -9613. You can also mail your registration payment to: American Public Works Association PO Box 843742 Kansas City, MO 64184 -3742 Once the Purchase Order is received your registration will be confirmed. Badge Number: 201385 Reg Type: Pending Payment !Name: Michael McBride Company: City of Carmel,. Indiana Address 1: 1 Civic Scl Address 2: City. Carmel State /Province: IN Zip/Postal Code: 46032 -2584 Country: United States Phone: 3175712441 2 Scott, Lisa M From: Michael McBride [mtm6274 @yahoo.com] Sent: Monday, October 03, 2011 2:42 PM To: Scott, Lisa M Subject: Fw: Final details for your 9/14/2011 trip to Denver Forwarded Message From: Expedia Travel Services <usmail @expediamail.com> To: mtm6274 @yahoo.com Sent: Sunday, September 11, 2011 4:24 PM Subject: Final details for your 911412011 trip to Denver SME xpedia- Flights I Hotels I Cars I Vacation Packages I Cruises I Activities I DEALS OFFER; Dear Mike, Here are itinerary and confirmation numbers for your trip to Denver. Travel Tools For more specific details, see the My Itineraries in your Expedia Account. Travel advisories, tips, and more in: Traveler alerts Plan ahead: Due to recent TSA changes, please be sure to allow extra time at the airport. Arriving early will help you avoid long -lines or possible delays. Learn more (D Receive your flight itinerary via cell wc�5 phone with Expedia To Go Airline baggage policies /fees Several airlines now assess a service fee (each way) for checked bags. Select airlines also instituted fees for oversize bags and items requiring special handling. Read airline baggage policies Important trip deta ils Main contact: Mike Mcbride Traveler(s):1 Expedia itinerary number(s): E -mail: mtm6274 @yahoo.com Traveler: Michael Mcbride 138721814857 Home phone: (765) 649 -4228 Business phone: Mobile phone: Is your information correct? Update contact information Don't Forget the NEW Expedia Facebook App Get the app now and discover the best things to see and do on your trip. Download the Facebook app Itinerary Wednesday, September 14, 2011 My Account Flight Airline phone numbers Airline rules and restrictions i American Airlines confirmation code: Travel Tip: Use this code to check in BDQZMV Depart 11:50AM Indianapolis (IND) American Airlines Arrive 1:15PM Dallas (DFW) Flight 1897 19F, Economy /Coach Class, S80 2 Hr 25 Min Saturday, September 17, 2011 Flight Airline phone numbers Airline rules and restrictions Frontier Airlines confirmation code: <Travel Tip: Use this code to check in JTROVP Depart 10:35AM Dallas (DFW) Frontier Airlines Arrive 11:29AM Denver (DEN) Flight 123 17A, Economy/Coach Class, AIRBUS INDUSTRIE A318 1 Hr 54 Min Wednesdays September 21, 2011 Flight Airline phone numbers Airline rules and restrictions Frontier Airlines confirmation code: <Travel Tip: Use this code to check in JTROVP Depart 11:35AM Denver (DEN) Frontier Airlines Arrive 4:00PM Indianapolis (IND) Flight 618 23F, Economy/Coach Class, Airbus A320 2 Hr 25 Min Helpful links More Traveler Tools Plan the rest of your trip We can help find the ideal car, hotel al E -mail Customer Service or call 1- j Use our Gas Station Finder to activity everything you need to treat+ 800 EXPEDIA (1 -800- 397 3342), locate stations and compare prices. perfect trip to Denver. Log in to your Expedia Account See services at more than 64 And with our Best Price Guarantee yof f airports with Airport Guides always get the best deal. Confirm flight schedules and times with Flight Status CD S e e m ore Traveler Tools Never miss a deal Get the latest offers, fare sales, and more! Q Sign up for travel deals e-mail Flights I Hotels 1 Cars I Vacation Packages I Cr uises I Activitie I Deals& De I Rewards You are receiving this transactional email based on a recent booking or account related update on Expedia.com To use the Application, you first need to create a Facebook account at www.facebook.com All use of Facebook is governed by the Facebook Terms of Use which cai accessed at www.facebook.comlterms.php Your use of the Application is also governed by the Trip Companion terms of use which can be accessed here. These lim exclude aspects of, Expedia's liability. 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(EMID: ETM_TGPT_1.0_X_X_C_EN)(MD: 20110911022429)(EPID: 0 %PAID %%)(ETID: 399031) 2 ILi "i uiy i.lu rc�ul� 1 Q�G 1 UlL Dallas, TX OtExp Booked items Flight: Indianapolis to Dallas back to top Expedia itinerary number: 138721814857 Main contact: Michael T McBride Airline ticket number(s): 4228678475348 E -mail: mtm6274 @yahoo.com American Airlines confirmation code: BDQZMV Cell phone: 1 3177143022 Frontier Airlines confirmation code: JTROVP Preferred phone: 1 3177477025 Alternate phone: 1 3175712438 Traveler and cost summary Michael McBride Adult Add Frequent Flyer number(s) $377.00 Taxes Fees $32.10 Booking Fee 7.00 Total (Visa) $416.10 Change this flight Request seat changes Print a receipt View cancellation information Flight summary Seat assignments, meal preferences, and special requests must be confirmed with the airline; we cannot guarantee that they will be honored. Free and special meals are not available on many flights. Wed 14- Sep -11 Indianapolis (IND) to Dallas (DFW) 762 mi Depart 11:50 am Arrive 1:15 pm (1,226 km) AA Duration: 2hr 25mn Flight: 1897 Economy/Coach Class 19F S80 Total distance: 762 mi (1,226 km) Total duration. 2hr 25mn ItHP Sat 17- Sep -11 Dallas (DFW) to Denver (DEN) 641 mi Depart 10:35 am Arrive 11:29 am (1,032 km) Terminal E Duration: 1 hr 54mn Flight: 123 EconomylCoach Class( 17A), AIRBUS INDUSTRIE A318 Total distance: 641 mi (1,032 km) Total duration: 1 hr 54mn $P Wed 21- Sep -11 Denver (DEN) to Indianapolis (IND) 977 mi Depart 11:35 am Arrive 4:00 pm (1,572 km) Du ration: 2hr 25mn Flight' 618 Economy/Coach Class 23F Airbus A320 Total distance: 977 mi (1,572 km) Total duration: 2hr 25mn 1 Additional airline fees may apply at check -in Fees may be charged by airlines for services such as preferred seat selection and baggage handling. Please note that fees are determined by the airline you check in with and may change at anytime. See fees. http: /www.expedia.coiiV pub /ageiit.dll ?gscr= open &ltid 38721$14$ &vNvtp =4 9/12/2011 IMicimy LJ(J /LIOIYOJ/ 1. Q6c U1 Z_ Airline rules regulations Please note that the most restrictive set of rules applies to your entire itinerary. Indianapolis, IN (IND- Indianapolis Intl.) to Dallas, TX (DFW -AII Airports) Tickets are nonrefundable. A fee of $150.00 per ticket will be charged for itinerary changes after the tickets are issued, provided that the booking rules were followed. Dallas, TX (DFW -All Airports) to Denver, CO (DEN-All Airports) Tickets are nonrefundable. A fee of $50.00 per ticket will be charged for itinerary changes after the tickets are issued, provided that the booking rules were followed. Denver, CO (DEN-All Airports) to Indianapolis, IN (IND Indianapolis Intl.) Tickets are nonrefundable. A fee of $50.00 per ticket will be charged for itinerary changes after the tickets are issued, provided that the booking rules were followed. o Tickets are nontransferable and name changes are not allowed. This price includes a nonrefundable $7.00 booking fee. Please read important information regarding airline liability limitations Prices do not include baggage fees or other fees charged directly by the airline. Other penalties may apply. See an overview of all the rules and restrictions applicable for this fare. View the complete penalty rules for changes and cancellations associated with this fare. Special requests We will forward your requests to the travel vendor, but as these are subject to availability we can not guarantee that they will be honored. Some special requests (e.g., ski racks, rollaway beds) may incur additional charges from the vendor. Free and special meals are not available on many flights. Flight: Indianapolis to Dallas to Denver to Indianapolis Customer Support Itinerary number: 138721814857 If you have questions about your reservation, fill out our itinerary assistance form We'll respond within 24 hours: For immediate assistance call Expedia at 1- 800 EXPEDIA (1- 800 397 -3342) or 1- 404 -728- 8787 and have the itinerary number ready. bttp: /hvww.expedia.com/ pub /agent.dll ?gscr= open &itid 387218148 &vwtp =4 9/12/2011 Hyatt Place Dallas /Garland Sep 17, 2011 §H H YAT T PLACE www.hyattplacedallasgarland.com 3:14 am 5101 President George Bush Highway Garland, TX 75040 Telephone: (972 )414 -3500 Fax: (972 )414 -3550 MIKE MCBRIDE Folio 34156 200 N 5TH ST Room Number: 402 GARLAND, TX 75040 Rate: $107.00 Pay Method: VS911 S Arrival Date: Wednesday, September 14, 2011 Departure Date: Saturday, September 17, 2011 Member None Entered Information: 28JULI1 11:20:12 WRITTEN CNF DE Date Department Reference Voucher Room debit Credit 9/15/2011 16everage 113everage 30202 1402 1 $4.50 I agree that my liability for all charges is not waived./your privacy is important to us. Balance: Please visit us at www.hyattplace.com to review our Privacy Policy. Signature RESERVATION CHANGE Page 1 of') McBride, Mike T From: Franz, Allison [AFranz @ci.garland.tx.us] Sent: Tuesday, September 13, 2011 12:10 PM To: McBride, Mike T Subject: FW: Hyatt Place Dallas /Garland Update MIKE MCBRIDE 9/14/2011 58787878 Mike, Below is your revised hotel confirmation with a checkout date on Saturday. TeATE is paying for one night of your stay, so you will only be charged for two nights. See you tomorrow! Allison Franz Transportation Department City of Garland (97 2 05 -2 437 From: Hyatt Hotels [maiIto: Concierge @HyattE- Concierge.com] Sent: Tuesday, September 13, 2011 11:07 AM To: Franz, Allison Subject: Hyatt Place Dallas /Garland Update MIKE MCBRIDE 9/14/2011 58787878 Customer Service I Hotel Website I Print E -Mail I View Online ri RESERVATION CHANGE H Y AT T s CONFIRMATION NUMBER: 58787878 CHECK -IN DATE: Wednesday, September 14, 2011 HOTEL CHECK -IN TIME: 15:00 CHECK -OUT DATE: Saturday, September 17, 2011 HOTEL CHECK -OUT TIME: 12:00 a` Hyatt Place Dallas /Garland 5101 President George Bush Garland, TX 75040 US Tel: +1 972 414 3500 Fax: +1 972 414 3550 f y r 9/13/2011 RESERVATION CHANGE Page 2 oi'3 MIKE MCBRIDE, Greetings from Hyatt Place Dallas /Garland, Your reservation at Hyatt Place Dallas /Garland has been changed to new stay dates. Details of your reservation are provided below. We look forward to welcoming you on your Wednesday, September 14, 2011 arrival. Warmest Regards, Hyatt Place Dallas /Garland Team N= WN M (09 Allow us to help you plan activities and services prior to your arrival. Learn More about your destination here: DINING t GUEST SERVICES Fresh and convenient, learn Allow us to make your stay f more about our dining more comfortable with these t options, Click H I t services and amenities. Click t ons. ere. 11 a. r Here. ACTIVITIES VIRTUAL TOUR Make your vacation more Explore our hotel prior to A memorable and explore your* your arrival by viewing our z destination with these virtual tour. Click Here. exciting activities. Click Here. i JOIN HYATT GOLD z" INTRODUCING THE PASSPORT HYATT CARD Enjoy free nights, exclusive Receive two nights at any services and benefits at Hyatt anywhere in the world, Ilk Hyatt ho tels worldwide. anytime, just for using your card the very first lime. &ERMMX MMEWERM mu" 99 GUEST NAME: MIKE MCBRIDE NUMBER OF ADULTS: 1 NUMBER OF ROOMS: 1 NUMBER OF CHILDREN: 0 ROOM(S) BOOKED: KING BED ROOM DESCRIPTION: Free WIF1:42in TV:wet /dry bar:Contl breakfast Hyatt Grand Bed:Cozy Corner sofa sleeper 9/13 /2011 RESERVATION CHANGE Page') of 3 NIGHTLY RATE PER ROOM: September 14, 15, 16 107.00 US DOLLARS RATE INFORMATION: TYPE OF RATE: TEXAS INSTITUTE CANCELLATION POLICY: CANCEL BY 3PM CST 24 HOURS PRIOR TO ARRIVAL Changes to the dates of stay, number of guests per room or number of rooms confirmed will be subject to current pricing which may be different than previously confirmed rates. PREFERENCES: Your preferences have been submitted with your reservation and are subject to hotel availability. ADDITIONAL TAX SERVICE CHARGES: GUARANTEED BY: DIRECT BILL TO COMPANY 13.00% tax As a valuable Hyatt guest, you will also receive an arrival reminder notice. If you wish to unsubscribe from receiving reminder e -mails for confirmed reservations, please click here If you have opted -out on a previous confirmation, please disregard this message. 4 v r, ra r y r i A 41 Add to my address book FOLLOW US ONLINE: We respect your privacy and will only use your information in accordance with our Global Privacy Policy for Guests, available at privacy. Hyatt.com. If you have questions or comments regarding this email, please contact us at consumeraffairs @hyatt.com. You have a right to access, to rectify and to object for legitimate reasons to the processing of your data in accordance with our Global Privacy Policy for Guests. As used in this statement, the terms "we 'bur "Hyatt" and "Hyatt Hotels Resorts" encompass hotels managed, franchised or leased by subsidiaries and affiliates of Hyatt Hotels Corporation. The trademarks HYATT, HYATT HOTELS RESORTS, PARK HYATT, ANDAZ, GRAND HYATT, HYATT REGENCY, HYATT PLACE, HYATT SUMMERFIELD SUITES, HYATT GOLD PASSPORT, HYATT VACATION CLUB, and related marks are trademarks of Hyatt Corporation or its affiliates. 2011 Hyatt Corporation. All rights reserved. 9/13/2011 TRAVEL/EXPENSE REIMBURSEMENTS For: Oct. 3, 2011 Mile a a to Milea a Back Parking Other Total Miles Total Date Meeting Description Start Finish Start Finish Cost Costs Other Description Miles x $.555 Expense 8/30/2011 Towne Rd. Progress Meeting (131st 38109 38121 $0.00 $0.00 12 $6.66 $6.66 Shelborne) 9113/201 1 Towne Rd. Progress Meeting (131st 38681 38692 $0.00 $0.00 11 $6.11 $6.11 Shelborne) 9/14/2011 ITE APWA Conferences Trip To Airport 38713 38791 $0.00 $0.00 78 $43.29 $43.29 (Home To Indy Airport) 9/1412011 Baggage Check Fee $0.00 $20.00 IrontierAirlines Flight $0.00 $20.00 9/21/2011 Cab to Denver Airport $0.00 $56.00 $0.00 $56.00 9/21/2011 ITE APWA Conferences 8 Days Per Deim $0.00 $480.00 $60 x 8 $480 $0.00 $480.00 9/21/2011 APWA Denver Hotel Expense $0.00 $758.04 Hotel $0.00 $758.04 9/21/2011 ITE APWA Conference Return from Indy 56306 56388 $0.00 $0.00 82 $45.51 $45.51 Airport to Home 9/22/2011 Meeting with INDY DPW Regarding 96th 56447 56498 $0.00 $0.00 51 $28.31 $28.31 Keystone (DPW Office) $0.00 $0.00 $0.00 $0.00 $5.00 $0.00 $0.00 $0.00 $8.00 $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 Refund Total $1,443.92 Prescribed by State Board of Accounts MILEAGE CLAIM General Form No. 101 (1955) TO DR. Governmental Unit r YAGL On Account of Appropriation No. for (Office, Board, rtment or I titution DATE FROM TO ODOMETER READING' NATURE OF BUSINESS AUTO MILES MILEAGE 20 f Point Point Start Finish TRAVELED PER MILE 1 I S ►'12 fv v� J i Ra w 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 9953, 1 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 Clciirn No. Warrant No. I have examined the within claim and, hereby certify as follows: IN FAVOR OF ekz!�Z.&— That it is in proper form; That it is duly authenticated as required 1 by law; That it is based upon statutory authority; That it is apparently correct incorrect On Account of Appropriation Nam for Disbursing Officer Allowed 20 (D in the sum of n G� CD �o In t7 D m m (B=d or Coninussion) H a O FILED o a (D F5 C) m o n En m (ofbcial Title) LO 0 C Q. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 Maki M �I,�C Purchase Order No. G ynj r_ylo� &Aqx. Infi Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) DfA Total 2 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. ALLOWED 20 IN SUM OF s3. ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the i C} materials or services itemized thereon for 3F which charge is made were ordered and received except AM 20 j ft�rndure T e Cost distribution ledger classification if claim paid motor vehicle highway fund