244442 04/21/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 358641
ONE CIVIC SQUARE JENNIFER BROWN CHECK AMOUNT: $*******125.28*
CARMEL, INDIANA 46032 400 JORDAN ROAD CHECK NUMBER: 244442
INDIANAPOLIS IN 46217 CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 125.28 TRAVEL FEES & EXPENSE
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
4113115 S- v (,ILS 10f1-99 y 3 13 0 v v tViVvt1 10 . 5 3 0. S T .Suwi�r.� a JS
qJ131II; -00v-0 -N'(34 PixP DST �uvnvnJ 201�-
4 11q I I IzZ ' S I08I 9 'f3 3o 0 -"V-GzI -F(,ej 9 6%r 50. dU D S1" 6amm"� 20) s
+11 iq 3W - -v 1 t�66 OSI- �wmvKjq Ul
All receipts should be attached in the same order as listed above. t
No sales tax will be reimbursed. _T TOTAL: 1 a J Z
Employee Name(print) �l I ��i V- 0VV V)
Address APR IS 2015
payable heck tY P 1 S ) � N �(� 21 1 BY:
to: Ci , St,Zi
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Signature: Approved by:
Date: I� f Date:
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Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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indiana's.mntV conference design ad pedfically for rata-of-schooil time program providers!
DATE
INDIANA SUMMITLOCATION
APRJ1 :33 J14, 2015 oN OUT-OF-SCHOOL-LEARNING JW MARRIOTT INDIANAPOLIS
R
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.
358641 Brown, Jennifer Terms
400 Jordan Road
Indianapolis, IN 46217
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/15/15 Reimb Travel expenses for OST Summit 2015 $ 125.28
Total $ 125.28
I 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.
358641 Brown, Jennifer Allowed 20
400 Jordan Road
Indianapolis, IN 46217
In Sum of$
$ 125.28
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 125.28'i_ 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
April 17, 2015
Signature
$ 125.28 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I