HomeMy WebLinkAbout218944 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00353070 Page 1 of 1
ONE CIVIC SQUARE DAVID MCCOY CHECK AMOUNT: $130.51
CARMEL, INDIANA 46032 c/o
o� C/o is CHECK NUMBER: 218944
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 30 . 51 EXTERNAL TRAINING TRA
1201 R4341980 26421 03 . 27 . 13 100 . 00 WELLNESS PROGRAM
i
Prescribed by State Board of Accounts General Form No 101(1955)
/� n /� p MILEAGE CLAIM :N'J r M r�li v( V F CAI\M aLL— TO ` 1) / ' CCV( DR.
Governmental nit
On Account of Appropriation No. for
(Office,Board,Department or Institution
t
DATE FROM TO ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE @ 541.
201 Point Point Start Finish TRAVELED PER MILE
-J 40 t MIL Vo LIcr:- t-fAMIILT6tj ce H i w Y 14 1
2-7 C . MT POUC E i ILWN c0 tiT12 L 1
Auto License No. TOTALS 1
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after
allowing all just credits,and that no part of the same has been paid.
Date Z _ t
VOUCHER NO. WARRANT NO.
David McCoy ALLOWED 20
c/o IS Department IN SUM OF $
$30.51
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO#/Dept. INVOICE NO, ACCT#/TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1202 I 43-430.02 I $30.51
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
Friday, April 05, 2013
"
Director , IS
Title
Cost distribution ledger classification if
claim paid motor 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 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))
$30.51
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
CITY OF CARMEL WELLNESS PROGRAM
PRIZE/REWARD STATEMENT
Date: March 27, 2013
Name of Prize/Reward: First Quarter Weight Loss Challenge
First Place - Male
Amount: $ 100.00
Line Item: 419-80
Check Made Out To: David McCoy
Please Return Check to Sue Wo"ang► in Human
Resources
APR 0 8 1013
By U
VOUCHER NO. WARRANT NO.
ALLOWED 20
McCoy, David
IN SUM OF $
Employee
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26421 I 03.27.13 I 43-419.80 I $100.00 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
Wednesday, April 03, 2013
Director, HR
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))
03/27/13 03.27.13 1st Qtr Weight Loss Challenge $100.00
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