HomeMy WebLinkAbout205305 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 364842 Page 1 of 1
ONE CIVIC SQUARE KATHLEEN VASIL
CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK AMOUNT: $117.00
CARMEL IN 46033
CHECK NUMBER: 205305
CHECK DATE: 1/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 117.00 FOOD BEVERAGES
Brookshire Golf Club
Carmel, Indiana
Substitute Form 4070A
Employee's Daily Record of Tips
Employee Name (please print) kc VC S Payroll gs
Day Date Total Tips Received
Saturday
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday I X A
Total Weekly Tips
Substitute Form 4070
Employee's Report of Tips to Employer
Em to ee's Name and Address Employee's Social Security Number
Cash Tips Received from record above
Employer's Name and Address Period for which tips were received
City of Carmel From (date)
One Civic Square
Carmel, IN 46032 To (date
Employee Signa e V a Date
_..._..Y. u.
i
3
E
Food Beverage Tax 117.00
F
Amount Due
Tax •e
Total e
Deposit Received
Balance Due o
TheRMIC.s for letting us .serve Jr ®u®
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/09/11 Kump12 -9 -11 Kump Tip $117.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Kathleen Vasil
IN SUM OF
3779 Simmerman Court
Carmel, IN 46033
$117.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 Kump12 -9 -11 42- 390.40 $117.00 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
I which charge is made were ordered and
received except
Tuesday, January 03, 2012
4
Director, Brook ire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund