244194 04/15/15 / '. CITY OF CARMEL, INDIANA VENDOR: 367943
s® 31 ONE CIVIC SQUARE TRACI BROMAN CHECK AMOUNT: $***.....35.98*
CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 244194
CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 REIMB 35.98 GENERAL PROGRAM SUPPL
Carmel * Clay
Parks&Recreation APR 0 2015
LBY
Employee Expense Reimbursement Request =--__--_
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
3/ 115 WnV1n DMU% IDqb loo 41-M o3q cn. pr m.su 395.01 5 vot . cn
All receipts should be attached in the same order as listed above. ��•
No sales tax will be reimbursed. TOTAL:
Employee Name(print) "i'1 MA Rypm an
Address Iy1432 orange., Blossom -TH
Check
payable to: City, St, Zip
Signature: Approved by:
Date: �I3I I rJ Date: 5
Business Services Division,Revised 7-7-08
FILE: Shared\Adminisirative\Forms\Staff Forms\Employee Exp Reimb Request
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 Bromari Traci Terms
14432 Orange Blossom Trl
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/28/15 Reimb Dunkin Donuts Volunteer Appreciation. $ 35.98
Total $ 35.98
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
Voucher No. Warrant No.
i.
367943 Broman,Traci Allowed 20
14432 Orange Blossom Trl
Fishers, IN 46038
` InSum.of$
$. 35.98
I
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
{ Board Members
Dept#r INVOICE NO. CCT#/TITL AMOUNT
1096-60 Reimb 4239039 $ 35.9$ 1 hereby certify that the attached invoice(s), or
j: 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
I
April_9,2015
r .
Signature
$ 35.98 Accounts_PayableCoordinator .
Cost distribution ledger classifcation if Title
claim paid motor vehicle highway fund
I