HomeMy WebLinkAbout172700 05/26/2009 -Ati CITY OF CARMEL, INDIANA VENDOR: 065950 Page 1 of 1
ONE CIVIC SQUARE DIANA CORDRAY
CARMEL, INDIANA 46032 1 1843 STONEY BAY CIRCLE CHECK AMOUNT: $856.23
CARMEL IN 46033 -9501 CHECK NUMBER: 172700
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CHECK DATE: 5/26/2009
DEPARTM T ACCO UNT PO NUMBER INVO ICE NUMBER AMOUNT DESCRIPTION
1701 4343004 856.23 TRAVEL PER DIEMS
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CITY OF CARMEL Expense Report (required for all travel expenses)
!NOIPI+A EXHIBIT A
EMPLOYEE NAME: DEPARTURE DATE: S f f q TIME: M PM
DEPARTMENT: RETURN DATE: a3 TIME: PM
REASON FOR TRAVEL: IC. �C./�UCs� h DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas /Tolls! Meals
Date p Luggage Parkin Lodging Misc. Total
Taxi Tips Lu a e g Breakfast Lunch Dinner Snacks Per Diem
v
L9 .3.
I Y y. 4 0
0.ot r 5q. A
Total a-p 0 6
DIRECTOR'S STATE ENT: I hereby affirm that alkexpenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
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City of Carmel Form ER06 Revision Date 3/18/2009 Pagel
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Name Address
CORDRAY, DIANA Room 17105/K1
11843 STONEY BAY CIR Arrival Date 5/19/2009 12:53:OOPM
Departure Date 5/23/2009
CARMEL, IN 46033 -9501
US Adult/Child 210
Room Rate 159.00
RATE PLAN C -11M
HH# 348692524 SILVER G Zi a
AL: US #999L7R4
BONUS AL: CAR:
CONFIRMATION NUMBER 3335977745
5/22/2009 PAGE 1
DATE DESCRIPTION ID REF. NO CHARGES CREDITS BALANCE
4/13/2009 KBRU 10185083 $183.49
5/19/2009 GUEST ROOM RLEG 10312909 $159.00 n
5/1912009 OCCUPANCY TAX RLEG 10312909 $24.49 The iltonl amity
5/20/2009 GUEST ROOM RLEG 10316599 $159.00
5/20/2009 OCCUPANCY TAX RLEG 10316599 $24.49
5/21(2009 GUEST ROOM RLEG 10320589 5159.00
5/21/2009 OCCUPANCY TAX RLEG 10320589 $24.49 Hilton
5/22/2009 PARKING SELF IIM EGOP 10322647 $60.00
5/2212009 GUEST ROOM DEBE 10323449 $138.00
5/22/2009 OCCUPANCY TAX DEBE 10323449 $21.25 coNnno
5/22/2009
$0.00
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AUTHORIZATION
INITIAL
18265C
PURCHASI'S SrkvlCrS
17 East .k4onroe Strc ^t Chicago, Illinois 60603 -5605
Phone (312) 726 -7500 Fax (312) 917 -1707 TAXES U 5 A
We Holm You Enjoyed Your Stay
For Reservstions ar any Hilton Hotel Worhvide TIPS MISC. Qf)iriul Sponsor
Call Your Travel Agem or 1 -800- HILTONS
For Billing Inquiries Please Call (312) 726 -7500 TOTAL. ANIOUNT
We look forward to serving you again snort.
iI I:RC H, \,NDfSIE \NIYOR SLR \'ICE-$ PURCHASED OWN TU15 CANU SHALL NOT BE RFS01.17 OR RLTIJRNI:n FOR A CASH REFUND. PA YINIENT D1Jf UPON RI, eE111F fY
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AFFIDAVIT FOR EXPENSES
I, Diana L. Cordray, incurred expenses while on City business (IIMC) for which a
receipt was not possible. The following non receipted expense(s) is as follows:
Hotel Bellman $10.00 May 19, 2009
Diana L. Cordray
Clerk Treasurer
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))
S
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 NO. WARRANT NO.
ALLOWED 20
IN SUM OF
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
materials or services itemized thereon for
which charge is made were ordered and
received except
A 44 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund