HomeMy WebLinkAbout233974 06/25/14 *`.v�q,, CITY OF CARMEL, INDIANA VENDOR: 367943
® 3�, ONE CIVIC SQUARE TRACI BROMAN CHECK AMOUNT: $*******182 96*
x. �: CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 233974
°M;,oN�.` CHECK DATE: 06/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 182.96 GENERAL PROGRAM SUPPL
I
Carmel • Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
W-0/1 q MarSvn (Nb (00 Z+2a>9039 G .fir m.S� lISS t 2`�. lb F00d C01MPA-
10A0
All receipts should be attached in the same order as listed above. r� 1
No sales tax will be reimbursed. TOTAL:
Employee Name(print) TYMU Pjnm ay)
Address�31`Z Rncbvie�N py. �t A
Check /�
payable to: City, St, Zip �1(\ `��IN �-�Cb` A0
Signature: Approved by: -
Date: OM f ILA Date: (4-9
Business Services Division,Revised 7-7-08
7JUN
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request 1 1 2014
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.
367943 Broman, Traci Terms
9372 Benchview Dr., Apt A
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
6/9/14 Reimb Food for Campout $ 182.96
Total $ 182.96
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in adbordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
i.
Voucher No. Warrant No.
367943 Broman,Traci ' Allowed 20
9372 Benchview Dr.,Apt A
Indianapolis, IN 46240
In Sum of$
$ 182.96
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
Po#or Board Members
Dept# INVOICE NO. ALCCT#rrITLE AMOUNT f
1096-60 Reimb 4239039 $ 182.96 I 1 hereby certify that the attached invoice(s), or
r bill(s)is(are)true and correct and that the
f materials or services itemized thereon for
which charge is made were ordered and
received except
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I' 19-Jun 2014
+. Signature
$ 182.96 i Accounts Payable Coordinator
Cost distribution ledger classification if i Title
claim paid motor vehicle highway fund
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