HomeMy WebLinkAbout173725 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00350319 Page 1 of 1
ONE CIVIC SQUARE ELAINE BASS CHECK AMOUNT: $90.94
CARMEL, INDIANA 46032
CHECK NUMBER: 173725
CHECK DATE: 6/24/2009
DEPARTMENT A CCOUNT PO NUMBER I NVOICE NUMBER AM DESCRIPTION
1180 4343004 90.94 TRAVEL PER DIEMS
GIFT SHOP h r22
4618278 DIE COKE 2' OZ. 2.69
SUBTOTAL 2.69
SALES TAX 0.19
TOTAL 2.88
CASH (5.00)
CHANGE 2. 12
Cshr 9966: Amand,, 8 9 25
Register: R[G2 Jon 3 2009 12:51 RM
i,nk You
RP'Wrns, rc, ii or•jOinal race ipt
RetUrtIS n00- UO 'Ke II)EICIP within 30 0;:V/-,
GIFT SHOP 4 522
40002 CLASSIC COKE 20 2.69 T
SUBTOTAL 2.69
SALES TAX 0.19
7
TOTAL ?.88
CASH (3.00)
CHANCE 0.12
Csh/ 9966: Amanda 849 8 26
Register: REC2 Jun 3 2009 12:52 PM
Thank YOU
Returns require original recaivr
Ae'turna need to be made wiz|/in �0 days
G Tl,� I SHOP 4 522
.1 1
5'1'656 DIET COKE WITH L 2. T
SUBIOTAL. 2. 69
SALES) TAX 0.19
TOTAL 1 1 1 .88
CASH 3.00)
(.'HAN(',E 0.12
Cshr 9966: Amanda FW H 26
Register: REG2 Jun 2 2009 1 :1.2 PH
Thank You
RetL11 need to be made within 30 dav,
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
GOV ANMENTAL
I /11 P1C! Al�C1JJyX�
ON ACCOUNT OF APPROPRIATION NO. '�3� y FOR
a p)111�C l l t ]IOARD, DEP E TOR INSTITUTION)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING
NATURE OF BUSINESS MILES Q i SS
POINT POINT START FINISH TRAVELED PER MILE
3 el 19710
a lie
AUTO LICENSE NO, TOTALS 3
i
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, 1 hereby certify that the foregoing'account is just and correct, that the amount claimed is legal due, a #ter ali ing all just credits
end tliat n part of the same has been paid.
Date o
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
C CwCbGLJ 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
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in the sum of ro
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(Board or Commission) G. rt
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A.E. BOYCE CO., INC. MUNCIE, ON 01136
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STATE OF INDIANA
SS:
COUNTY OF HAMILTON
AFFIDAVIT
I, A. Elaine Bass, being first duly sworn upon my oath, state that while I was on City business
attending Laserfiche training in Indianapolis, Indiana, on June 2 3, 2009, I expended $46.00 of my own
money for parking and for which I need to be reimbursed.
Dated this day of June, 2009.
i
S A. Elaine Bass
Subscribed and sworn to before me, the undersigned Notary Public, this X day of June, 2009.
NOTARY PUBLIC
Resident of 6oz, e. County, Indiana
My Commission Expires'.
Leh :msword:zashared+alTidavits \Aus atTadivit- pzrking.doc:61% /09]
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
z 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.
Elaine Bass Payee
Purchase Order No.
8832 Powderhorn Way
Terms
Indianapolis, Indiana 46256
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6 -5 -09 Reimburse Elaine Bass for monies she personally 54.64
expended while on Uty business June
—the attaGhodl receipts and Affidavit
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. $54.64
20
Clerk- Treasurer
VOU NO. WARRANT NO.
ALLOWED 20
A. 'Llaine Bass IN SUM OF
8832 Powderhorn Way
I ndianapolis, IN 46256
$54.64
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
430 57002 External Training Fees
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT_ I hereby certify that the attached invoice(s), or
1180 54.64 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
20
ature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund