216774 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 355319 Page 1 of 1
0 ONE CIVIC SQUARE MICHAEL KLITZING CHECK AMOUNT: $51.00
CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE
!+ BROWNSBURG IN 46112 CHECK NUMBER: 216774
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 51 . 00 TRAVEL FEES & EXPENSE
I
Carmel a Clay
Parks&Recreate®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
13"000 Travel from airport to hotel(NRPA
1/3/2013 National Cab Company, Houston, TX 101 1125-1-1125-1-43552 Travel Fees & Expenses $36.00 Program Committee Mtg.)
Travel from hotel to airport(NRPA
1/5/2013 Fast Cab, Houston, TX 101 1125-1-4343000 Travel Fees & Expenses $15.00 Program Committee Mtg.)
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $51.00
Employee Name (print) Michael Klitzing
Address 1550 Redsunset Dr.
Check
payable to: City, St, Zip Brownsburg, IN 46112
Signature: Approved by:
Date: 1/15/2013 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
FA*T uA
Fare Receipt
Tel: 281-879-0271
n� Date ► I
Received of `"`'�< <(
The Sum of 4 15- C_a.aLq
From l+� AMcJ•�a - �L-,
Fast Cab
No. Driver
J" J .
FAST CAB
Tel: 281-879-0271 .
c ae chauje a",awtb
and &pw,6o Drift W Seudce aaai&dfie
NATIONAL CAB COMPANY
HOUSTON,TEXAS
713-649-4145
TAXICAB FARE RECEIPT
Date:
Received of
Fare $31--
From ���- �Sy
To
Driver Name Cab No.
Driver Cell Phone
All Taxicabs are Operated by Independent Contractors.
r
i
Voucher No. Warrant No.
355319 Klitzing, Michael Allowed 20
1550 Redsunset Dr
Brownsburg, IN 46112
In Sum of$
$ 51.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
i
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 Reimb 4343000 $ 51.00 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
24-Jan 2013
Signature
$ 51.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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.
355319 Klitzing, Michael Terms
1550 Redsunset Dr Date Due
Brownsburg, IN 46112
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
1/5/13 Reimb NRPA Program Committee IMtq taxi M.Klitzin $ 51.00
f
Total $ 51.00
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