HomeMy WebLinkAbout230610 03/26/14 11�r.C,AMf!
CITY OF CARMEL, INDIANA VENDOR: 359285
® ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $ ......71 71.70-
CARMEL,CARMEL, INDIANA 46032 2703 E LYNN ST CHECK NUMBER: 230610
M,r>a„�` ANDERSON IN 46016 CHECK DATE: 03126/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 71.70 TRAVEL FEES & EXPENSE
Carmel ® Clay -r"r
Par ks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# (audget Description �( Amount Purpose of Expense
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $ ry
Employeen Name(print) \ a � ),�kc' ,J� M?1112c {S j I
Address
Check _
payable to: City, St, Zip
Approved by:
Signature: 1 1Ji(�(.'ti�'lJ��.� -'� L .
U
Date: Date:
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
359285 Simmonds, Valeska Terms
2703 E Lynn St Date Due
Anderson, IN 46016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
3/10/14 Reimb Travel expenses NAA Conference $ 71.70
f
Mileage 11/6- 12/27/13
Total $ 71.70
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
i
Voucher No. Warrant No.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of$
$ 71.70
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 71.70 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
20-Mar 2014
Signature
$ 71.70 i Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund I