227583 12/27/2013 CITY OF CARMEL, INDIANA VENDOR: 365819 Page 1 of 1
ONE CIVIC SQUARE JILL JOSEPH CHECK AMOUNT: $18.21
ti CARMEL, INDIANA 46032 3538 BRIDGER N DR
CARMEL IN 46033 CHECK NUMBER: 227583
CHECK DATE: 12/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 18 . 21 FOOD & BEVERAGES
/�y of CAgiy\
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7 CITY OF CARMEL Expense Report (required for all travel expenses)
���NOIANP/- EXHIBIT A
EMPLOYEE NAME: �� �� �Cf�[ l�H DEPARTURE DATE: /��� TIME: AM/PM
DEPARTMENT: /�oI RETURN DATE: TIME: AM/PM
REASON FOR TRAVEL: DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
p LodgingMisc. Total
Date Air-fare Car Rental
6tHer Parking Breakfast Lunch Dinner Snacks Per Diem
r
211
}
r
Total
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: Z,2 —/ ��-
Page 1
City of Carmel Form#ER06 Revision Date'10/17/2006
Brookshire Golf Club
Carmel, Indiana
Substitute Form 4070A
Employee's Daily Record of Tips
Employee Name (please print��` ���' ��� Payroll #
Day Date Total Tips Received
Saturday
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Total Weekly Tips
:k
Substitute Form 4070
Employee's Report of Tips to Employer
Employee's Name and Address Employee's Social Security Number
el- /(✓ �� Cash Tis Received from record above
MVEmployer's Name an"ddress Period for which tips were received
City of CaTf From (date) /Z--
One
zOne Civic Square
Carm- /460 To (date)
Employee re Date
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jill Joseph
IN SUM OF $
3538 Bridger N Drive
Carmel, IN 46033
$18.21
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I TIP DEC13 I 42-390.40 I $18.21 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
Thursday, December 19, 2013
Director, Brookshire �if Club
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))
12/13/13 I TIP DEC13 I Banquet Tip I $18.21
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