HomeMy WebLinkAbout204832 12/20/2011 ti CITY OF CARMEL, INDIANA VENDOR: 00350224 Page 1 of 'I
4I ONE CIVIC SQUARE NANCY HECK CHECK AMOUNT: $1,389.79
CARMEL, INDIANA 46032
CHECK NUMBER: 204832
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343001 160.00 TRAVEL FEES EXPENSE
1160 4463000 1,229.79 FURNITURE FIXTURES
eted �yc�sfgtnerPle s pant clea
Tole compl rly
Customer Warne (Print) P
SAL 121 1 418r4
8 BILLIN[ CT!)tfiTL
Address ttY f J Lti t L' L 1 Y Y r Cppt.'S
Tax Eaemp t 0 2497329 a5
MJRT Tui AU as
e
�To b8 cam leted b c'stgmer Please pant clBarlyr�p E, ab' city/State TOTriL Zip Code 219
W -Fly Y
VISA 219. i5
C �tomer Name (Print), Phone 1� rig �'xxxxxxxXxiCxi44ii'�J AAf14iti
A�I�� {lrt t•( 3i� 1/y� r r, 1 Q 14 fuTN 012168
Address Apt. e n Cl #ANu "E 0
��e C rti►z c�c�f rt E SOLD P,6E.
City/State U Zip Code Customer Order Number
_I
0393000010329320'111212
CLi r v Date rare sold Nerchandi.se
to be ?irked ar
SKU Deserirtion 9t'/
2497320 BILLINGS E -TRSTL 1
v Pre Sold Merchandise restocked i :j%
Picked up or delivery accepted u;
Pier I lmr t5 M 10 days of a6eve Pick f ie date.
7 14311 CLAY TERRACE BLVD, SUITE 14e isefEttr€i will be Processed,
t. (317)816 -0529.
Nitre: City ref Caroel
Associate a-001 Brian ___..i
Address: x
Store $1470 Res 02 Trans 045 4 x
SALE 12/12/11 11;33an i City: tlarrip
P HCORIAE TABLE
axate: Ill
21-09430 IP 349.99 349.99 SAI_ s Zip Code: f 2
P BILLINGS CTRSTL T
2497328 30 219.95 659.05 ail oZOne,
Tax Exempt cis 0031 20 1 550020
SUBTOTAL 1009.84 Customs, S
TOTAL 1009,84 �L;iNEiEttN ItiE.;
1007.84
ACCT -txxxxxxxxxxxx6043 YXIX7(
7 AUTHO 012698
PRE HA L P URCHASF
Customer Order Number
14700M20456420111212
Date Pre sold merchandise
to be ?irked up
1$/13/21 i< To be complete d by customer Please pnnt clear{y
SKU DescriPtion Illy Phone
4 2509430 t4C8RIDE TABLE 1 Customer N me
2447328 BILLINGS CTRSTL 3 �I� 0 Ym f Apt,
x Address
Pre Sold merchandise restocked if riot E(pt.oz
Picked up or delivery accepted within Zi p,
10 days of above Pick up date, city /State
Refund will be Processed, ��A�c I
Narte: City of camel
Address; 1 civic sivare
Apt, t. na
City: carmel
"tote: IN
Zip Code: 46032 Nancy heck contact
Telephone: 317-431-5309 Email:
CONTINUED ON NEXT PACE
Cus�#o er 5xsna4�r��
Fr
NANCY 5 HECK
Cardholder acknowledse5 receipt of
soods rind /or services in the arieant of
1V33 0 char -se tender amount -shown here
'g on
the m and agrees t Perform the o6111010115 set for
in the cardholder s
CUSTOMER FILE COPY
a -sreement with the user.
4 J 'Item 4892833 09 /07
ICssceed Uaw
II G� c� n 2 �S4o $aS -12/12/11 11 36ant c
l r e SALE_
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1
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b-L9 cy (-CC-1�—
F.
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO 151 of c y c i/ �ln T'PP1� Dt C�y1 e 4 G0 �53
(GOVERNME A UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM To READING ET +R
AUTO MILEAGE
NATURE OF BUSINESS MILES 2
POINT POINT START FINISH TRAVELED PER MILE
C
C 4-v A7,Q- 11 Y
1 Q e
C° i C: e- e- creme
CA
1 C) C
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3
C- G
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4 0 t U
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 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
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
o W w
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Allowed 19 0 w
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in the sum of co
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(Board or Commission) O rt
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A.E. BOYCE CO., INC. MUNCIE, IN 01136
PRESCRIBED BY STATE BOARD OF ACCOUNTS AL� GENERAL FOAM NO. 141 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOMETER
READING ET+
AUTO MILEAGE
NATURE OF BUSINESS MILES Q
�9 -i= POINT POINT START FINISH TRAVELED PER MILE
G
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o C.. 5 k d +C
t a
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-tom l
1
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S
AUTO LICENSE NO. i TOTAL
SPEEDOMETER READING, columns are to be used only when distance points cannot be determined by fixed mileage or official highway map. ���0
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 cre
and that no part of the same has been paid. L Date 1
Claim No. Warrant No. 1 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.
On Account of Appropriation No. for Disbursing Officer
p- A.
1-4 0 0
Allowed 19_
n 04 tr
w a
,q ro
in the sum of
ro
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(Board or Commission) 0 m 0 ZT
a'
FILED
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(Official Title) p ti
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P
LS
A.E. ROYCE CO., INC. MUNCIE, W 01136 a
VOUCHER NO. WARRANT NO.
ALLOWED 20
Nancy Heck
IN SUM OF
1326 Cool Creek Drive
Carmel, IN 46033
$1,389.79
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT /T1TLE AMOUNT Board Members
1160 Receipt 44- 630.00 $219.95 I hereby certify that the attached invoice(s), or
1160 Receipt 44- 630.00 $1,009.84
bill(s) is (are) true and correct and that the
1160 1 Mileage Claim 43- 430.01 $160.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, December 16, 2011
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Slate 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/12/11 Receipt $219.95
12/12/11 Receipt $1,009.84
12/16/11 j Mileage Claim $160.00
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