DEPOSIT SLIP .J~~~2,fiK~~: ~. ~~f~h:JJ!.:.~!b-:' .~~1-~~1:~t~~-f :· ·:!_:.7~·: :.. ' Division of Controller Office 850 Hungerford Drive, Room 154 Rockville, Maryland, 20850 [email protected]Print Form ] I ResetForm Requestor: ~ Cash D Check D Credit Card D Money Order Department: Board of Education Request Date: June 2013 School: Contact Name: Becky Gibson Customer Signature E-Mail: [email protected]Phone: 301-279-3617 Fax: 301-279-3860 Address: CESC,Room 123 ChrisBarclayReimbursement to AMEX I .~-- ·---- ·--- ..··--·-·--- -·-·-··· -··- - -·--- ·---- .. _..J -···· C0>h I Ch<i' Boccl'y Reirnbursernent to AMEX I Cash ·---------1 ChrisBarclayReimburse~-;~~~~----J--- ~2148 I I I ' I - I j ~_--==_+---==~- - ---=-_--=l =~---------------_I --j I I i i I I ~~-:-~=-----=-~=[-=:~-- ---- --- ~=-- ~==--1 ·: I - . . i . -.-------· ----·----+----------------------··----··---------------~------1-------------~--··------·------ ...··--- .. ---l..----------·- j ~ .. _ - 1 ---- - -- ---- -----··· --·--- ···-----·- ----- ----- ! --·--- ------~--- l_ -' $318.21 Receipts Confirmation for Customer Only '.f(_~~-~e_a_m_o_u_n_t __ of-----------~ Received Date I o/ ,;1--1!'3 Received By( $318.21 '----·--------
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'.f(_~~-~e_a_m_o_u_n_t__of-----------~ReceivedDate I o / ,;1--1!'3Received By( $318.21
'----·--------
PURCHASING CARDCard Member Transaction Log
Office of the Chief Operating OfficerDepartment of Materials Management
MONTGOMERY COUNTY PUBLIC SCHOOLS • Rockville, Maryland 20850~
MCPS form 234-21June 2009
Card member name Christopher Barclay
School/office name Board of Education
For the period: From June 29, 2013
Work location CESC, Room L23
To July 18, 2013 USE SEPARATE LOG FOR EACH ACCOUNT
Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or·other-must be identified.) (03, 05, etc.)
07/24/2013 07/24/2013 $31.00 Buffalo Wild Wings, College Park Dinner meeting 07/28/2013 504091
07/20/2013 07/2J/2013 $53.99 Chandler's Crabhouse, Seattle, WA Dinner mtg. during CUBE Conference 07/28/2013 50<1002
07/08/2013 07/l0/2013 $13. !O Du lies Gourmet, Dulles, VA Lunch during CUBE Conference 07/28/2013 504002 '
07/04/2013 07/05/2013 $336.70 1-Iotwire Sales, Online Travel Mistakenly used, will be reimbursed ~I\ 07/28/2013 504091
07/08/2013 07/09.12013 $211.00 Hotwire Sales, Online Travel Mistakenly used, will be reimbursed \)~ 07/28/2013 504091o,~
07/21/2013 07122/2013 $50.00 lAD Dulles Economy Airport parking during CUBE Conf 07/28/20 IJ 504002 v
07/08/2013 07/09/2013 $5.00 !AD DuJles Pay and Go Parking 07/28/2013 504002
Total $700.79
CERTIFICATION STATEMENT
I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school pro~ as outlined in the Purchase Card Guide. I understand that any materi9).f11isrepresentatiolJ. or orpission from this log maybe grounds for cancellationof my purchase card privVe~n<l/or disciplinary action.
_, '._fJ,~~- ~I~~ bff~~~£~ _/_/_or~ Date SianLJ7e. oorovtna Official Date
(0
.II
//
~,-------------------------------------~
PURCHASING CARDCard Member Transaction Log
Office of the Chief Operating OfficerDepartment of Materials Management
MONTGOMERY COUNTY PUBLIC SCHOOLS• Rockville, Maryland 20850~
MCPSForm 234-211[une 2009
Card member name Christopher Barclay
School/office name Board of Education
For the period: From June 29, 2013
Work location CESC, Room I23
To .July 28, 2013 USE SEPARATE LOG FOR EACH ACCOUNT
Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be identified.) (03, 05, etc.)
07/1112013 07/12/20 l3 $26.00 Nando's Peri-Peri, Silver Spring Lunch meeting with Marcus Moore 07/28/2013 504091 I.·
07/16/2013 07/17/2013 $13.20 New Fortune Restaurant, Gaithersburg Dinner meeting regarding construction 07/28/2013 504091
07/ 18/2013 0712012013 $18.06 Peso's Kitchen & Lounge, Seattle, WA Lunch while attending CUBE conf 07/28/2013 504002 ·-·07/2212013 07/23/2013 $27.00 Ruby Tuesday's, Linthicum, Meeting with constituent regarding 07/28/2013 504091 ,.
state construction money
07/18/2013 07/18/2013 $52.44 Seattle Yellow Cab, Seattle, WA Ground transp. while attending CUBE 07/28/2013 504002 ,__...
07/17/2013 07/l 8/2013 $25.00 United Airlines, Washington D.C. Baggage fee, flight to CUBE conf 07/28/2013 504002 ,_,.
07/20/2013 07/2112013 $1 l.58 United Airlines, Washington D.C. In-flight meal, flight from CUBE conf 07/28/2013 504002
(No receipt given)
Tota! $201.28
CERTIFICATION STATEMENT
I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school prog.r: is as outlined in the Purchase Card Guide. l understand that any material misrepresentation or om~sion from this log maybe grounds for cancellationof my purchase carc!"Iri e and/or disciplinary action. /l ·
-t--'~~ ~- _1?__/~-4 L/F'0A~d') f:_) /czt;14~J0r'~ _/_/~re, Card Member Dote~ Zionofure.Aoorovino Officia? Date
Card Member Transaction LogOffice of the Chief Operating OfficerDepartment of Materials Management
MONTGOMERY COUNTY PUBLIC SCHOOLS • Rockville, Maryland 20850~
MCPS form 234-21June 2009
Card member name Christopher Barclay
School/office name Board of Education
For the period: From June 29, 2013
Work location CESC, Room 123
To .luly 28, 2013 USE SEPARATE LOG FOR EACH ACCOUNT
Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be identified.) (03, 05, etc.)
07/21/2013 07/2:2/2013 $25.00 United Airlines, Washington D.C. Baggage fee, return flight from CUBE 07/28/2013 504002 :,_ .•..
For important informationregarding your accountrefer to page 2.
iiillil
For your records only - do not pay.
For assistance or questions about your account, contact us at www.americanexpress.com/checkyourbill orcall Customer Service at 1-800-492-4920.
Activity.Oare reilecls either transaction 0< posting dale
Card Numbe1 Reference Cede Amount$
31.00J07/24/13 BUFFALO WILO WINGS 0 COLLEGE PARK MD 00083583000_REF.#__QQ0835.a3 _ 30j_-.4.86c0333__..__.07/2-4./.1.3 .FOOD/BEVERAGE .ROG NUMBER 00083583
07/21/13 34200000000CHANDLERS CRABHOUSE SEATTLEREF# 342 206-223-2722FOOD/BEVERAGEROG NUMBER 342
53.99/WA07/20/13
J7/10/13 47361()(](]()(](]DULLES GOURMET MARKE DULLESREF# 47361 800-742-5030FAST FOOD RESTAURANROC NUMBER 47361
13.10VA07/08/13
J7/05/13 HOTWIRE-SALES FINAL 866-468-9473 CAREF# 8206513793~ TRAVEL .07/04/13
07/26/13 85101653207 28.00,iTHE WOODSIDE DELI SILVER SPRING MD851016532 USFC20910 07/25/13ROG NUMBER 8510165320798000
07/18/13 19980450000 25.00 ,/UNITED AIRLINES WASHINGTON DCTKT# 01626029425300 AIRLINE/AIR C 07/17/13SPECIAL SERVICE TICKETBARCLAY /FIRST CHECKED UNITED AIRLINESUNITED AIRLINES WASHINGTON DCFROM
. D_U_l,,1.,,1;$_A_RP.lQCTO
SEATTLE WATO
UNAVAILABLETO
UNAVAILABLETO
UNAVAILABLE
CARRIER CLASSUA DO
YY 00
yy 00
yy OD07/21/13 UNITED AIRLINES HOUSTON TX 20288999000 11.58
TKT# 01629205097730 AIRLINE/AIR C 07/.20/13SPECIAL SERVICE TICKETBARCLAY /INFLIGHT A LA UNITED AIRLINESUNITED AIRLINES HOUSTON TXFROM
DULLES ARPT DCTO CARRIER CLASS
SEATTLE WA yy DOTO
UNAVAILABLE yy 00TO
UNAVAILABLE yy 00TO
UNAVAILABLE yy DO07/22/13 UNITED AIRLINES SEATTLE WA 20381251000 25.00/
TKT# 01626031605962 AIRLINE/AIR C 07/21/13SPECIAL SERVICE TICKETBARCLAY /FIRST CHECKED UNITED AIRLINESUNITED AIRLINES SEATTLE WAFROM
YELLO\l\J._.GARDSERVIC)2·6} INC.206-6?2-65Q07 //'y- T/ /_,PUACJASER S)~'HERE ef?.J-x f /'--···----,f~---<---~~Cardh01der acknowledges'recdipt of goods and/or services in theamount ol ·the Total ?hown hereon· and agree lo perform theobligations set forth in the Cardholder.'s ogreemenl with tile Issuer.
.~-)·(
·i~~:07/18 and 07/20 - Yellow Cab Services, Inc.Ground transp. while attending CUBE conf
YELLOW CARD SERVICES, INC.206-622-6500 ,,..PURCHASER SIGNH~~E/,/r"~i /r,c"x / ~/ ..-ft~)·-~-- ~----Oardhnldw ricknoWledgeS rcCelfJl"d"r~ffOcf~j"ar{dforservices in theamount of the Tota(shown -tiereon and agree to partormstheobligations. set lorlh ln _l_heCardholdar'e _agraem)n_twith th~..Issuer,
f') _r~•_/l-·
>o,0o
.Rl\.TE\__ / ., .., . I I CLERK~-) .f.:.1 / ,i( / /?AUTHORIZfl]joi:r"/ r_.-ISERVEA
-1 _O_TY__-1-0-Es_c_ni_PT-ION--1--M-IOW_T __ I .: :a:.·.f2.to:::>-o
280073
SUB ,,..-.... •YELLOW CARD SERVICES, INC. TOTAL /·) . j)206-622:,&!S"go/J t{!!y TAX /PURCHAS(R SIGN0:~E / -) . S LES - i ';-;'-"IX / ---z."~~-~.--"'---~~·~..... A ,/,.: =» L-'-~ ---- -..~-=- . · ,.'• .SLIP ,__,. ' --cardholder acknowledges r<i'ceipt of goods and/or services in.'the~·:·::·if / i 'I'amount of the Total shown hereon and agree to perform :t,ie.:'.~;1~)~ / · ·1 • ()/'.obllgations set forth in the Cardholder'sagreementwithnhe.lsSuar=.'..1::..,;~~ I J·. .. .
Cardholderacknowled s receipt of goods and/or services in lhe Cj , ,amount of the Total ·hown hereon and agree to perform the / 1<:,rC)obligutions set forth In the Cardholdcr's ;;igreement'wlth the Issuer. -:· J
C H ~t I S : ;_; P H t F·:~- ~~c p s t~ I1 T ;'; -: ~ it i I t . t ·) < - ~
r S ·-·. !.• :~lH::_-J\TfL:-: )/;:<fl S!lG ?O I R09S: ·a r-' .-._r· 1>. t • r:
YELLOW CARD SERVl~ES, INC .•--1 • I
206-622-6-5110/ </PURCHASE_i Sl~~!J'.iERE ~X ( /Y----/.~ ' -~Card holder acknowledqiS"receipt at goods and/or services in theamount of the Total Shown hereon and agree to perform theobligations set forth in the Cardholder's agreement with the Issuer.
Return to Work!istDDisplay next notification after my response
Copyr,\Jlit (c) 2006, Oracle. Ali rights reserved. Privacv Slatement
PURCHASING CARDCard Member Transaction Log
Office of the Chief Operating OfficerDepartment of Materials Management
MONTGOMERY COUNTY PUBLICSCHOOLS " Rockville, Maryland 20850~
MCPSForm 234-21June 2009
Card member name Christopher Barclay
School/office name Board of Education
For the period: From July Z9, 2013
Work location CESC, Room 123
To August 28, 2013 USE SEPARATE lOG !FOR EACIHACCOUNT
Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be identified.) (03, OS, etc.)
I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card lqg are correct and complete. Allpurchases were made insupport of school programs as otiitlined in the Purchase Card Guide. I understand that any material misrepresentation or omission from this log maybe grounds for cancellation
-01-=F m,,..Lx,.'l!.~:..!..<'.~as&.eZ!_c~a~[!Lk:pr::'::iv~H~geL:~~isciplinaction. _1L;_l_;_L3_ \JJ p~ _jj_;_L;Sig1 ture, Card Member Date · Siqn~rovinq Official Date -!!5-
For important informationregardingyour accountrefer to page2.
For your records only - do not pay.
For assistance or questions about your account, contact us at www.americanexpress.comicheckyourbiii orcall Customer Service at 1-800-492-4920.Activity Dale reflectseithertransactionor postingdale
Status Performer Approval GroupNotified Gibson, Rebecca MCPS_IEXPENSE_APPROVER_GROUPS
Comments
Related Applications@l Expense Report Details
Copyright (c) 2006, Oracle. All rights reserved.
Please click here to Respond
2
~
MONTGOMERY COUNTY BOARD OF EDUCATIONRockville, Maryland
May 22, 2013
MEMOR.A.NDUM
To: Mrs. Susan Chen, ControllerDivision of Controller Qw>
Ikhide Roland Ikheloa, Chief of Staff~ -From:
Subject: Check Request Payable to Christopher Barclay, ID
Please issue a check in the amount of $32.50 in reimbursement of the attached receiptsfor transportation and meals while attending meetings and deposit check.
Please charge the account numbers indicated.
Mr. Christopher Barclay$14.00 - BOE Expense .$18.50 - Out of State .
Thank you.
IRJ:rlg
Attachment
C}t 091'.W13 - Montgomerv Countv Council Bui Iding. Cafeteria -Lunch meeting with Council Member Valerie Ervin
04/ 16/2013 - Santiago's Cab - NSBA Conference -Ground Transportation to Airport from Hotel
TO Ar r pDrtCAB# AMOUNT$ d 3. SDDRIVER DATE_!±_I 11!2._ I~
Thank. You - Call UsAgain
619-420-9589 or 619-690-5870. from Mexico Tel: 664-630-12-43
04/13/2013 - NSBAConferenceSnack while attending conference
'iOUR RECEIPTTHANK YOU
1J4/13/2013 3; 30PM O 1-100000#5091 CLERkO1
.PECIAL COQl{lf i2.5U~PECIAL COOKIE $2.50
~TPISCAS': ''.>. 00
PURCHASING CARDCard Member Transaction Log
Office of the Chief Operating OfficerDepartment of Materials Management
MONTGOMERY COUNTY PUBLICSCHOOLS • Rockville, Maryland 20850
MCPS Form 234-211June 2009
~
Card member name Christopher Barclay
School/office name Board of Education
For the period: From August 29, 2013
Work location CESC, Room l 73
To September 28, 2013 USESEPARATElOG FOREACH ACCOUNT
Date Ordered Date Delivered Total Amount Supplier Name Supplies/Services (required) Statement Date Account($) (Student or other-must be ideritified.) (03, 05, etc.)
09/19/2013 0912012013 $4.45 DC Parking, Washington Parking, Congressional Black Caucus 09/28/2013 504001
Annual Leg. Mtg. (missing receipt)
09/12/2013 09113/2013 $34.99 La Madeleine, Rockville, Lunch meeting with R. Smondrowski 09/28/2013 504091
09/12/20 l3 0911212013 $3.00 MCG DOT, Silver Spring Garage Parking, Montgomery Moving 09/28/201 J 504001
Forward Event
09/ 17/2013 0911.8/20 l 3 $31.79 Staples, Rockville Supplies for iPad, Stylus 09128120 l3 503030
09106120 l3 09/07/2013 $32.00 The Wine Harvest, Potomac Lunch meeting with R. Srnondrowski 09/28/2013 '504091
09119/20 l3 0912012013 $14.00 The Woodside Deli, Silver Spring Meeting (missing receipt) 09/28/20 l3 50409!
Total $127.23
CERTlflCATION STATEMENT
I certify that, to the best of my knowledge, the transactions recorded for the month indicated on this purchasing card log are correct and complete. All purchases were made insupport of school programs as outlined ir;))le Purchase Card Guide. I understand that any material misrepres tion or omission from this log maybe grounds for·cancellationof my/p'V"c~e cardfrivil~ and./~~. ~Ii nary action. . . -rr
UU4/~A/L,-,; A.c;L,&:h . JL;_I_; 1'3 lL1LtLDate Date