HomeMy WebLinkAbout210531 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00353077 Page 1 of 1
ONE CIVIC SQUARE DENNIS RUSS
0 CHECK AMOUNT: $30.00
t �?o. CARMEL, INDIANA 46032 C/0 CARMEL WASTEWATER
CARMEL IN 46032 CHECK NUMBER: 210531
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 30.00 EMPLOYEE PENSIONS B
CITY OF CARMEL Expense Report (required for all travel expenses)
\�NDIAN�
2010 mileage reimbursement rate is 50 cents /mile
EMPLOYEE NAME: Dennis Russ DEPARTED na TIME:
DEPARTMENT: Utilities /Sewer RETURN na TIME:
REASON FOR TRAVEL: na DESTINATION CITY: na
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X_ TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch I Dinner I Snacks Per Diem
5/24/12 Operator certification renewal $30.00 $30.00
$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
0.00
Total $0.00 $0.001 $0.00 $0.001 $0.001 $0.001 $0.001 $0.00 $0.00 $0.00 $30.00 e
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:
City of Carmel Form ER06 Revision Date 6/26/2012 Page 1
sa. Department of Eosirmuuental Management
0f6ce of Water Quality Mal Code 6+42
I001 N. Senate Ave.
ludianapolis. IN 46204 -2251
Wastewater Operator Class i
CertifirrtionN Effeetice Date Expiration Date
VVW017 0 07/01/2012 06/ 012014
Dennis M. Russ
�O DENNIS M RUSS Bank: 561
BIl1VK
IMAGE STATEMENT
3343 .e
rRew�fius
t 1p. En
f- MMUNI7Y K{ o a
R-1M D r
�.600Qtggo) 3
AMT: 30.00 SEQ: 80401860 AMT: 30.00 SEQ: 80401860
CK: 3343 DT: 05/24/12 ST: Paid CK: 3343 DT: 05/24/12 ST: Paid
End Statement 04147716E
VOUCHER 125188 WARRANT ALLOWED
T9967 IN SUM OF
RUSS, DENNIS
CARMEL WASTEWATER
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
052412 01- 7042 -06 $30.00
Voucher Total $30.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
I
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T9967
RUSS, DENNIS Purchase Order No.
CARMEL WASTEWATER Terms
Due Date 6/26/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/26/2012 052412 $30.00
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
cer
Date