243678 03/31/15 Q
CITY OF CARMEL, INDIANA VENDOR: 358408
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECKAMOUNT: $*******202,03*
CARMEL, INDIANA 46032 5057 E 71ST STREET CHECK NUMBER: 243678
INDIANAPOLIS IN 46205 CHECK DATE: 03/31/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 202.03 TRAVEL FEES & EXPENSE
Carmel ® Clay NOTA APTER$C14COL
Parks&Recreation ASSMATION
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
3 $ �` laced Naor�a� �c�5�;v►n� IO�bI-q4 o O
5- 2-0o 13
/�bl �� IS o-7 Livia)
311 IA 5-
-3/11
3/11 fl ' C-7 LUACV�
3>111115 C(ioct
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $
Employeen Name(print) I(\
MA? 19 2011
Address 5os 1 -E�
Check L'= - ----payable to: City, St, Zip
Signature: ln, WV V Approved by.
Date: Date:
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3
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Tiffany ,
Buckingham
Carmel Clay Parks & Recreation
Carmel, IN
United States
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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.
358408 Buckingham, Tiffany Terms
5057 E 71 st St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/16/15 Reimb. Travel expenses for NAA Conference $ 202.03
Mileage 11/11/14- 1/14/15
Total $ 202.03
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. `
7
358408 Buckingham,Tiffany Allowed 20
5057 E 71 st St
Indianapolis, IN 46205
In Sum of$
$ 202.03
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Po#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1081-99 Reimb. 4343000 $ 202.03 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
I received except
I,
March 25, 2015
1P. Ack&WA"
Signature
$ 202.03 Accounts Payable Coordinator
Cost distribution ledger classification ifTitle
claim paid motor vehicle highway fund
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