241531 1 /27/2015 +n.C,Ab
CITY OF CARMEL, INDIANA VENDOR: 369061
® ONE CIVIC SQUARE AMANDA JACKSON CHECK AMOUNT: $********35.54*
:9 ;=q: CARMEL, INDIANA 46032 14850 WAR EMBLEM DR CHECK NUMBER: 241531
.y��TON�°' NOBLESVILLE IN 46060 CHECK DATE: 01/27/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 REIMB 35.54 TRAVEL FEES & EXPENSE
Carmel • Clay PIAN 2 2 2 115
Parks&Recreation By.
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
1/14/2015 Taco Bell 1091 4343000 Travel Fees& Expenses ✓ $5.54 Food
1/14/2015 Arby's 1091 4343000 Travel Fees& Expenses ✓ $8.30 Food
1/15/2015 Options Buffet 1091 4343000 Travel Fees&Expenses ✓ $16.04 Food
1/16/2015 McDonald's 1091 4343000 Travel Fees&Expenses ✓ $5.66 Food
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All receipts should be attached in the same order as listed above.
reimbursed. L: 35.54
No sales tax will bee TOTAL:
$
Employee Name(print) Amanda Jackson
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Address 14850 War Emblem Dr.
Check
payable to: City, St, Zip Noblesville, IN 46060
Signature: q Approved by:
Date: 1 Date: t/2-2/11-
Revised
1Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp;Reimb Request 2007-3
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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.
Jackson, Amanda Terms
14850 War Emblem Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/22/15 Reimb IPRA Annual Conference Jan 14- 16, 2015 $ 35.54
Total Is 35.54
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IG 5-11-10-1.6
, 20_
Clerk-Treasurer
Voucher No. Warrant No.
Jackson,Amanda Allowed 20
14850 War Emblem Dr
Noblesville, IN 46060
In Sum of$
$ 35.54
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ON ACCOUNT OF APPROPRIATION FOR j
109 -Monon Center +
Dept#r Board Members
INVOICE NO. CCT#/TITL AMOUNT
1091 Relmb 4343000 $ 35.54 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
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January 22, 2015
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Signature
$ 35.54 Accounts Payable Coordinator
Cost distribution ledger classification if i Title
claim paid motor vehicle highway fund
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