pettycashcheckrequestpg2.xls
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lechevarria@coab.us
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pettycashcheckrequestpg2.xls
Melissa, please find attached the Petty Cash Check Request Form
Thank you
Linda Echevarria
City of Atlantic Beach
Billing Specialist
(904) 247-5835
<5afa970182fa40d19d5896ca027020c2@ABMAIL13.ci.atlantic-beach.fl.us>
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pettycashcheckrequestpg2.xlsSheet1
Form-Instructions Pg. 2
Form-Instructions Pg. 1
Form Pg. 2
Form Pg. 1
DATE
PAYEE
ADDRESS
CITY
STATE
ZIP CODE
DESCRIPTION
AMOUNT
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
TOTAL
SPECIAL INSTRUCTIONS
(14)
(15)
(16)
ACCOUNT DESCRIPTION
ACCOUNT NUMBER
REQUESTED BY / DATE
DEPT HEAD / DATE
CITY MGR / DATE
SPECIAL INSTRUCTIONS:
(17)
(18)
(19)
(20)
CHECK REQUEST
City of Atlantic Beach
NOTE: If possible, do not use a P.O. box
(5) - (7)
CITY, STATE, ZIP CODE
PROJECT NO.
VENDOR NO.
six digit alphanumeric number required when using element codes 61 - 63
NOTE: Contact the Deputy Finance Director, if you need assistance
dollar amount - for multiple accounts, breakdown by account number
NOTE: Initials and date must be hand-written, not electronically generated
DATE
go to GMBA application on the AS400, press option 1. "Inquiry
desired number - make sure vendor address in the system is
correct, before selecting the number for use
PAYEE
ADDRESS
Form Preparation Procedures
Menu", then press option 2. "Vendor Master", to obtain the
NOTE: If vendor not found, leave cell blank
name of person or company you want printed on the check
element/object description you want item or service charged to -
expense account, e.g, Operating Expenses - revenue account, e.g.,
Building Permit Fees
short description of item or service or reason for charges or reimbursement
DESCRIPTION OF ITEM OR SERVICE:
Subtotal from Page 2
WHEN CHECK REQUEST IS OVER $500
ADDITIONAL APPROVALS ONLY REQUIRED
Subtotal to Page 1
FINANCE DIR / DATE
To expedite processing, please attach adequate documentation to support payment.
TIP 1
This form is a "read-only" form. If you want to save your entries, you will need to save the form under a
different name. CAUTION: Changes may be made to the form periodically, so it is best to use the form
found on the F:\ drive each time you prepare a new request.
TIP 2
Go to the F:\ drive on Windows Explorer
Access the "City Policies" folder
To create a shortcut to access the "Check Request" Excel file from your desktop:
Right click your mouse on the "Check Request" Excel file
Select "Send To" and then "Desktop (create shortcut)"
TIP 3
Request" form, press the TAB key
LEGEND for Form-Instructions Pg. 2
address where check is to be delivered (three lines provided)
Subtotal from Page 2
total amount to be paid to the vendor (automatically calculated)
(15)
requests for attachments to be sent with check, special check handling, etc.
NOTE: As a general rule, to control the issuance of checks, all checks
processed via "Check Request" form will be mailed by the A/P Clerk.
SUPPORT DOCUMENTS
adequate documentation, e.g., invoices, receipts, etc., should be attached
to the "Check Request" form to provide support for payment
initials of person initiating check request and date of request
initials of applicable department head and date of approval
(19) - (20)
ADDITIONAL APPROVALS
the Finance Director and City Manager must initial and date all "Check
To move from the top to the bottom of the form and directly to the unprotected "input" cells on the "Check
account distribution
GL account number - use space provided on Page 1 and 2 for multiple
if more than three lines are required for account distribution, use Page 2 of
the "Check Request" form to enter the additional lines of information - the
subtotal from Page 2 input will automatically carry over to Page 1 and be
included in the "Total" check amount to be paid
Request" forms with a "Total" amount exceeding $500
date of request - auto filled with current date, however, can be changed
Page 2 of 2
Revised:
Effective:
5/10/04
5/19/04
800 Seminole Rd
Atlantic Beach
FL
32233
59
Petty Cash
.
Custodian: Carlene Matthews
001-6010-572-5200
Linda Echevarria
001-1007-512-5200
Batteries and water
Water for AITP
Battery for Phone
Picnic Games
001-1010-513-5200
Senior Luncheon @ Baker Ctr
K & T Nursery Sr Crafts
001-6010-572-52-00
Dollar General Sr Crafts
Artist Reception
Release fo Lien
001-1007-512-4900
BJ's Membership Rec
001-6010-572-5209
12:00:00 AM
59
City of Atlantic Beach
$37.88
7.00
10.69
16.00
75.87
22.96
5.00
59.03
10.00
40.00
$284.43
$0.00
.xls
pettycas.xls
pettycashcheckrequestpg2.xls
application/vnd.ms-excel