4801 West 50th Street

Edina, MN 55424

952-927-8861 Fax: 952-826-0390

City of Edina EXPENSE REPORT

Phone/Extension: Supervisor: Purpose of trip: e,...491.5— rr,,n/L 4- Celli

Title:

DATE:

,62,e— • Please attach all receipts.

Department:

•

Date Description Account .,•. Mflre-age-s Register Meals Hotel

I 694( Xer-Rerrt Phone Misc. TOTAL ?-30 5/1N-4n& 40*.S. 1 2-9/4

£o. 3 3.140

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2-G, 4,3 Z.- 0 - I/142-

...._ 24 . V/... K.e..t" 5.ei-itr- 01., z:cs.

.Y-144.petzt,Sfyill .6,1_ --11- 6,551- 637 s___— -v-1-

45-67,z-6 __I _

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-

1,04-, P i., sextteL LjZO c

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, TOTAL

9

Employee Name: AI

°

$0.575 per mile 2015 mileage rate

it 51. 5-5 please rerwiluers

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Employee Signature:

Loul ay Ki tchen 84 Bell-

600 Union Street Seattle, WA 98101

206-402-4588 e.com :58AM

XXXXXXXXXXXX41111 SWIPED PURCHASE 452855 1755 11/1 1041 James C

ma. Date: Card Type: Acct #: Card Entry: Trans Type: Auth Code: Check: Table: Server:

Subtotal:

Total:

* * * Custollier Copy * * *

TRANSACTION RECORD

Dragonfish 722 PINE STREET

SEATTLE, WA 98101

CARD TYPE:VISA Nu. **********A1111EXPI.: ENTRY :SWIPED Customer : SCOTT NEAL AUTHORIZATION: 964186

. STORE #:001 TERMINAL :2 REFERENCE:185975

$13.15

THANK YOU SEPTEMBER 28,2015 13:18:26

Server's name : PETER

CU OMER COPY UAL:

PURCHASE

TIP

TOTAL