217778 02/26/2013 a *f CITY OF CARMEL, INDIANA VENDOR: 241253 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH
s CHECK AMOUNT: $91.69
CARMEL, INDIANA 46032 cio rocs
cio rocs CHECK NUMBER: 217778
CHECK DATE: 2/2612013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343001 33 . 00 TRAVEL FEES & EXPENSE
1192 4355100 38 . 69 PROMOTIONAL FUNDS
1192 4357004 20 . 00 EXTERNAL INSTRUCT FEE
Your payment to 360 Event Planning
Inibox.x �` v
David Littlejohn via PayPal <member @paypal.com> 4:50 PM (2 minutes
ago)
to me
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You sent a payment of$10.00 USD to 360 Feb 19,2013 13:50:33 PST
Event Planning. Receipt No:0599-1068-8683-3195
Hello David Littlejohn,
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Merchant information: Instructions to merchant:
360 Event Planning None provided
hemandeza360eventplanning.com
hftp:/Avww.360eventplanning.com
7654305958
Shipping information Shipping method
David Littlejohn Not specified
4840 Guilford Ave
Indianapolis, IN 46205
United States
Description Unit price Qty Amount
Purchase from 360 Event Planning $10.00 USD 1 $10.00
USD
Insurance: ---
Total: $10.00 USD
9th Annual Purdue Road Sc oai
Thank you for registering.To return to the Purdue Road School veb site
Name: David Littlejohn
Confirmation Number: KGNM35HCF86 (needed to modify your registration) f
David Littlejohn Event Title: 99th Annual Purdue Road School
I 1
2
Optional Items
i Optional Item Cost i
€ 2 Day"A" Parking Permit Valid 3/5-6/2013 $10.00 x 1 = $10.00 i
Tuesday evening Welcome Reception $0.00 x 1 = $0.00
i.........................................................................................................................................................................................................................................................................................................................
Order
Date Type Amt Ordered Amt Paid Amt Due
02/13/2013 4:33 PM ET offline order $0.00 $0.00 $0.00
02/19/2013 4:50 PM ET offline order $10.00 $10.00 $0.00
Total: $10.00 $10.00 $0.00
Payment Details
Details
Date Type Reference# Amt Paid
02/19/2013 PayPal PayPal $10.00
1
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1217 S. RANGELINE RD.
317-846-4818 \
YOUR CASHIER WAS SELF C:HECKOUF
FOLGR COFFEE 9.88 F
MXHS COFFEE PC. 7.79 F V �
KRO WATER 3.89 F
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—2'1`.`56
CASH"- 20.00
CASH 1 .00
CASH 1 .00
CHANGE 0.44
TOTAL NUMBER OF IrEMs SOLD 3
02/08/13 01 :35pm 959 85 70 5'99
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We Value Your Feedback!
ENTER TO WIN ONE OF 20 $100 GIFT CARDS
You are invited to comple+e o sure-,
about taour recent visit to Kroger
Answer bar Internel @
www. tellkroger.com
You will need this receipt to respond
SURVEY ENTRY COOL:
021 999
pj
JOIN KROGER PLUS & B IN Sm'ING TODAY
YOU COULD HAVE SAVED $0.80
THANK YOU FOR SHOPPING kROGER
CUSTOMER SERVICE IS EVERYONE'S JOB.
LET ME KNOW HOW WE ARE DOINGi.
CHARL BECHEL, MANAGER
s
S
Motr, Lisa
From: customerservice @www.IN.gov
Sent: Friday, January 25, 2013 9:51 AM
To: Motz, Lisa
Subject: SOS Notary and Renewal receipt
Thank you for using the SOS Notary and Renewal online at www.IN.gov. Your transaction is
complete. Your receipt identification number is 5300675. Please reference this number in
any correspondence regarding your transaction.
Payer Information
LISA MOTZ
8675 LUANN STREET
NOBLESVILLE, IN 46062
Phone 317 - 773 - 1174
Email lmotz @carmel.in.gov
Account Information :
4***********3915 exp. 07/13
Transaction Details :
Description Unit Price Quantity Extended Price
Notary Application Fee$5.00 1 $5.00
Instant Access Fee $1.12 1 $1. 12
Total :$6.12
The following amounts have been charged to your credit card. Your credit card statement
will show the following merchant name(s) and amount (s) for this transaction.
Merchant Amount
IN Sec of State 800-236-5446 $6.12
The total amount charged to your credit card is $6.12 .
1
February 22, 2013
To: Cindy Sheeks
From: Lisa Stewart
Affidavit of a petty cash expenditure.
Please be advised that I, Lisa M. Stewart took$10.00 from the petty cash fund to purchase paper goods
for the retirement party for Ramona Hancock and have misplaced the rec t.
i
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• About Carmel
• Business Directory r.
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• Member Center !r
• About Us 1'
• Join the Chamber
Advocacv
Event Registration
January Luncheon /
Event Date(s): 1/9/2013 /
Event Tune:12.00 PM to 1:30 PM
Your sign up information has been processed
Please print this information to keep for your records.
Thank You.
Your Contact Info:
Adrienne Keeling
1 Civic Square
Carmel,IN 46032
Phone:3175712417 Ext:
Emal akeeling @carmeLUm.gov
1 - Chamber Member- Prepay-20.00
TOTAL:20.00
Your Card Info:
Credit Card Type:
Card Number:
Expiration Date:6 2014
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If you'd rather place your order by telephone,please call(317)846-1049 or fax your registration along with your credit card information to(317)
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Copyright 02013 Carmel Chamber of Commerce.All rights reserved.
37 East Main Street,Suite 300 Carmel,IN 46032
Phone:317.846.1049
Open M-F 8:30 am-430 pm
Chamber Management Sohrtion
10580 X Mialdgan Road
-----------
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v O1129/2013, 10:52 AN anlft 1
Empl 65153, Bale Y 12008770582
_E::PAE83 ------8.00
Bubtot al B.D
Bales Tar 0
1 Total 8.00
• I Cash .,1 - 800
1
VOUCHER NO. WARRANT NO.
Petty Cash ALLOWED 20
DOCS IN SUM OF $
One Civic Square
Carmel, IN 46032
$91.69
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1192 43-551.00
bill(s) is (are)true and correct and that the
1192 43-570.04 $20.00
materials or services itemized thereon for
1192 43-430.01 $33.00 which charge is made were ordered and
1192 43-551.00 $38.69 received except
Frid , Fe ary 22, 2013
Directo
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
Ramona's party
02/22/13 Lunch training $20.00
02/22/13 Parking, Mike, David x2 $33.00
02/22/13 notary,tea, coffee, etc. street dept. $38.69
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