HomeMy WebLinkAbout228191 1/15/2014 CITY OF CARMEL, INDIANA VENDOR: 359065 Page 1 of 1
ONE CIVIC SQUARE BOB HIGGINS
? 0 CHECK AMOUNT: $216.40
CARMEL, INDIANA 46032 16133 HYMERA GREEN
WESTFIELD IN 46074 CHECK NUMBER: 228191
CHECK DATE: 1/15/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 46 .40 TRAVEL PER DIEMS
1207 4357002 170 . 00 EXTERNAL TRAINING FEE
Prescribed by Slate Board of Accounts MILEAGE CLAIM General Form No.101 (1955)
—�— `
�r P �'� �S TO (91)ELL �.i J DR.
(Governmental nit)
On Account of Appropriation No. v�6 - �Zl� for
ffice�3F�oar , Department or nstitution
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS [AUTO
MILES MILEAGE @�20 Point Point Start Finish RAVELED PER MILE
X -36--5 S' 19 / v
S Orl-75 ao
Auto License No. TOTALS
* 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 —,&A,y �� 0
i
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as requi
by law;
That it is based upon statutory autho:
That it is apparently correct
- •- •o��... incorrect
On Account of Appropriation No. for
Disbursing Officer
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First Name Middle Initial assIt Name
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2.
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Q Cost Amount
Member Nonmember # Due
Tradeshow Only Badges $10 $20
Registration: Education&Tradeshow(#t&2) $130 ea $170 ea
Ea.additional member: Ed.&Tradeshow $45 ea S 170 ea
One Day Only(Education&Tradeshow) $90 ea $120 ea
Workshop (Letter) $70 ea $120 ea
Tradeshow Lunch(Thursday only) $15 $15
Association/Foundation Membership see application
Total Amount Due 1 I-D
Make all checks payable to Indiana Green E_rpo or charge
Circle: Visa Mastercard Discover
Signature
Officese: v
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.4tV OF Caq,H�(\
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CITY OF CARMEL Expense Report (required for all travel expenses)
ON ANpEXHIBIT A
Ii�
EMPLOYEE NAME: DEPARTURE DATE: �' -/ TIME: AM /PM
DEPARTMENT: 2,207 RETURN DATE: TIME: AM/PM
REASON FOR TRAVEL!/, 910 DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM
Transportation a Gas/Tolls/ Meals
Date Parkin Lodging Misc. �T;otaI!.:
Air-fare Car Rent t ther g Breakfast Lunch Dinner Snacks Per Diem
la77
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'1,
tel:
;.17?
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DIRECTOR'S STATEMENT: 1 hereby affirm that II expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date'10/17/2006 Page 1
WELCOME TO
PLA2A PARK
PLEASE KEEP THIS TICKET
WITH YOU
Entered/Arriuee:
2014/01/09 07:54
Ticket/Billet#:34274120
Dur/Duree:7:15:38
Paid On/Paye Le:
2014/01/09 15:10
Paid/Paye:$ 24.U0
Original Fee:$ 24.1111
CST:$ 0.00
PST:$ 0.00
Change:$ 0.00
MASTERCARD
SC:$ 11.110
Merchant ID:
*******...**
Seq# 1637U2694 01203
Purchase 14/01/(19 15:117:32
Auth# 757555
RPPROUED
k'
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))
01/13/14 I Trade Show I Bob Higgins Trade Show $216.40
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Bob Higgins
IN SUM OF $
$216.40
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I Trade Show I 43-553.00 I $216.40 1 hereby certify that the attached invoice(s), or
I 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
Monday, January 13, 2014
Z"5,- 2 A '41
Director, Brooks hlr Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund