HomeMy WebLinkAbout179130 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00353333 Page 1 of 1
ONE CIVIC SQUARE JEAN BELCHER
CARMEL, INDIANA 46032 CHECK AMOUNT: $293.00
CHECK NUMBER: 179130
CHECK DATE: 11/1112009
DEPARTMENT ACCOUNT P NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
1.701 4343004 293.00 TRAVEL PER DIEMS
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CITY OF CARMEL Expense Report (required for all travel expenses)
NO, EXHIBIT A
DEPARTURE DATE: �Q. `I TIME: 6V P M
DEPARTMENT: RETURN DATE: /b 9 TIME: -s s AM
REASON FOR TRAVEL: DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Parkin Lodging Misc. Total
Air -fare Car Rental Other g Breakfast Lunch Dinner Snacks Per Diem
11/1/09 $65.00 $17.00 $75.00
11/2/09 $65.00 $8.00 $73.00
11/3/09 1 1 $65.00 $5.00 $70.00
11/4/09 $65.00 $10.00 $75.00
$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
$0.00
0.00
Totall $0.00 $0.001 $0.001 $0.001 $0.001 $0.00 $0.00 $0.001 $0.001 $260.001 $33.00
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.
Director Signature: Date:
r
-City of Carmel Form ER06 Revision Date 11/10/2009 Page 1
I, Jean A. Belcher, affirm that I incurred these expenses related to my conference
attendance and travel to the Sungard Conference in Hershey PA November I 4, 2009.
Jean A. Belcher
9
Date
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))
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
(X
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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund