HomeMy WebLinkAbout219499 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN STORMS
€ CHECK AMOUNT: $174.77
�* CARMEL, INDIANA 46032 CHECK NUMBER: 219499
ITON GO
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 174 . 77 TRAVEL FEES & EXPENSE
i GENERAL FORM 110.161%Mfi)
FAESCRIRCD BT STATE HOARD OF ACCOUNTS
MILEAGE CLAIM
TO
(OOVfaNNCN7AL UN111 ON ACCOUNT OF APPROPRIATION NO. FOR
(OF710E,BOARD,DEFAATHII(T OA INSTRUTION)
SPEEDOMETER AUTO MILE
FROM TO READING .I- NATURE OF HUSINES6 A4LES ��
DATF,� TRAVELED
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AUTO LICENSE NO. TOTALS `-7 '-J J
+ 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
APR x 2913
Carmel e clay
-'arks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
a
q >, C�C 6-. C en-� V for 11 b v-q`( 3 q (- Dp ✓ or i
3 art S/ 0?1- ga X13 q saw T,�I ��s
C10/1 400 C?IX-V VT'6�A I Res �-E,�ca a�e 1 2 q
Hf V1,5 C;rcb- le,/- o+ ��
All receipts should be attached in the same order as listed above. /
No sales tax will be reimbursed. TOTAL:
Employee Name(print) ll r(Y�S
Address
Check
payable to: City, St, Zip E /V 6
Signature: Approved by: },
Date: Date: /
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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.
363382 Storms, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
3/28/13 Reimb" Mileage 3/4 - 3/28/13 $ 97.57
4/15/13 Reimb NAA Conference expenses $ 77.20
I
Total $ 174.77
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
20_
Clerk-Treasurer
Voucher No. Warrant No.
363382 Storms, Meagan Allowed 20
In Sum of$
$ 174.77
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
Board Members
PO#or INVOICE NO. AC CT#/TITLE AMOUNT
Dept#
1081-7 Reimb 4343000 $ 97.57 1 hereby certify that the attached invoice(s), or
1081-99 Reimb 4343000 $ 77.20 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
18-Apr 2013
Adw
Signature
$ 174.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund