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174362 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00351325 Page 1 of 1 ONE CIVIC SQUARE DAVID HUFFMAN �o CARMEL, INDIANA 46032 C/0 STREET DEPARTMENT CHECK AMOUNT: $13.50 4 roM `o C/0 STREET DEPARTMEN CHECK NUMBER: 174362 ti CHECK DATE: 7/8/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4343002 13.50 EXTERNAL TRAINING TRA 4 ,,A OF CAh C Q,RT \fq. CITY OF CARMEL Expense Report (required for all travel expenses) �NDIANp EMPLOYEE NAME: DEPARTURE DATE: TIME: AM PM DEPARTMENT: RETURN DATE: TIME: AM/PM REASON FOR TRAVEL: C�I�L�S 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 6/18/09 $5.50 $5.50 6/22/09 $8.00 $8.00 $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 $0.00 0.00 Totall $0.00 $0.001 $0.00 3.501 $0.001 $0.001 $0.001 $0.001. $0.001 $0.00 DIRECTOR'S STATE ENT: I hereby affirm that all expense i onform to the City's travel policy and are within my department's appropriated budget. 'Director Signatur Date: r City of Carmel Form ER06 Revision Date 6/22/2009 Page 1 For advance payments, claim form must be submitted ten (10) business days in advance of travel. Claim will not be processed without the following documentation: 1) Conference or course registration form, if applicable 2) Travel itinerary or car rental agreement, if applicable 3) Original itemized receipts for all expenses (or affidavits if appropriate), except for meal per diems (which require hotel receipt) Prorated meal allowance: For travel that commences before 1:00 p.m. (flight departure time, if traveling by air), $50 for in -state travel and $60 for out -of -state travel For travel that commences after 1:00 p.m. (flight departure time, if traveling by air), $25 for in -state travel and $30 for out -of -state travel For travel that ends before 1:00 p.m. (flight arrival time, if traveling by air), $25 for in -state travel and $30 for out -of -state travel For travel that ends after 1:00 p.m. (flight arrival time, if traveling by air), $50 for in -state travel and $60 for out -of -state travel EMPLOYEE ACKNOWLEDGEMENT OF MEAL ADVANCE AND OBLIGATION TO DOCUMENT EXPENDITURES: I hereby acknowledge receipt of such funds being advanced to me by the City of Carmel solely for the purpose of purchasing meals while traveling to participate in official business for the City. I accept responsibility for these funds and agree to repay them if lost or stolen. understand that within ten (10) business days of my return (as stated on opposite side), I am responsible to: 1) Submit original itemized receipts to the office of the Clerk- Treasurer documenting all meal expenditures; and 2) Return all unused funds to the office of the Clerk- Treasurer I further understand that failure to provide the required documentation shall result in the total amount of the advance being deducted from the first paycheck issued more than 30 days after the date of my return. Failure to return unused funds will result in the amount of the unused funds (total advance minus documented expenditures) being deducted from the first paycheck issued more than 30 days after the date of my return. Employee Signature: Date: City of Carmel Form ERO6 Revision Date 6/22/2009 Page 2 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)) 06/26/09 $13.50 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 N W ARRANT N ALLOWED 20 Dave Huffman IN SUM OF $13.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 43- 430.02 $13.50 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 which charge is made were ordered and received except edn? �d y, July 01, 2009 Street Co4i sioner Strom Title Cost distribution ledger classification if claim paid motor vehicle highway fund