206427 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 357470 Page 1 of 1
ONE CIVIC SQUARE REBECCA SCHMIESING
CARMEL, INDIANA 46032 124 HILLCREST DRIVE CHECK AMOUNT: $416.26
WESTFIELD IN 46074 CHECK NUMBER: 206427
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 416.26 TRAVEL FEES EXPENSE
Carmel 0 Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
1/12/2012 Circle Center Mall 1125 4343000 Travel Fees Expenses $15.00 Parking Green Expo
1/13/2012 Circle Center Mall 1125 4343000 Travel Fees Expenses $15.00 Parking Green Expo
1/12/2012 Steak'n Shake 1125 4343000 Travel Fees Expenses $6.30 Lunch while Green Expo
►x.95
1/13/2012 Champps Americana 1125 4343000 Travel Fees Expenses Lunch while Green Expo
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 4
Employee Name (print) Rebecca Schmiesing
Address 124 Hillcrest Drive
Check
payable to: City, St, Zip Westfield, IN 46074
Signature: Approved by:
Date: Z Date: 2_-
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request
Carmel o Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
1/19/2012 Blue Chip Hotel and Casino The Game 1125 4343000 Travel Fees Expenses $9.42 V Dinner 1/16/12
1/19/2012 McDonalds 1125 4343000 Travel Fees Expenses $6.41 Lunch 1/18/12
1/19/2012 Blue Chi Hotel and Casino Nelsons Deli 1125 4343000 Travel Fees Expenses $3.20 Breakfast 1/16/12
1/19/2012 Blue Chip Hotel and Casino Options Buffet 1125 4343000 Travel Fees Expenses $21.39 Dinner 1/15/12
1/19/2012 1 Blue Chip Hotel and Casino Williams B's 1125 1 4343000 Travel Fees Expenses $17.12 Dinner 1/17/12
1/19/2012 Blue Chip Hotel and Casino Nelsons Deli 1125 4343000 Travel Fees Expenses $10.43 Lunch 1/16/1
1/19/2012 Blue Chip Casino 1125 4343000 Travel Fees Expenses $299.04 Hotel Stay for NRPA CPSI
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 1 $367.01 r
Employee Name (print) Rebecca Schmiesing
Address 124 Hillcrest Drive
Check
payable to: City, St, Zip Westfield, IN 46074
Signature: Approved by:
Date: O 2. Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Hdministrative \Forms \Staff Forms \Employee Exp Reimb Request
:r
BLUE CHIP CASINO
777 BLUE CHIP DRIVE
MICHIGAN CITY, IN 46360
CA51Nu fiO E-1 sFA For Express Check -Out Dial Guest Services
Name: REBECCA SCHMIESING Folio ID: 409232671206
Arrival Date: 01/15/2012
Address: Departure Date: 01/18/2012
Room No: BC 519
Guests: 1
Group Code: GIP0114
DATE REFERENCE DESCRIPTION CHARGES BALANCE
01/15/2012 409229000379 ROOM CHARGE BC 519 89.00
TAX1 6.23
TAX2 4.45
01/16/2012 409239000191 ROOM CHARGE BC 519 89.00
TAX1 6.23
TAX2 4.45
01/17/2012 409249000199 ROOM CHARGE BC 519 89.00
TAX1 6.23
TAX2 4.45
01/18/2012 409252683882 FD VISA 299.04-
************9701
SUMMARY OF CHARGES
ROOMS 267.00
TAX1 18.69
TAX2 13.35
.00
Check Out: Page:
Please call (888) 879 -7711 For Next Reservation or for any Billing Information
Thank You For Choosing Blue Chip Casino
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
357470 Schmiesing, Rebecca Terms
124 Hillcrest Drive Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/20/12 Reimb Indiana Green Expo Conference expenses 49.25
1/19/12 Reimb IPRA conference expenses 367.01
Total 416.26
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
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
357470 Schmiesing, Rebecca Allowed 20
124 Hillcrest Drive
Westfield, IN 46074
In Sum of
416.26
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 reimb. 4343000 49.25 1 hereby certify that the attached invoice(s), or
1125 reimb. 4343000 367.01 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
9 -Feb 2012
Signature
416.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
x