244921 05/05/15 0�! cggf. CITY OF CARMEL, INDIANA VENDOR: 369336
i2 ONE CIVIC SQUARE EMILY FRANK CHECK AMOUNT: $********84.49*
r ,=a; CARMEL, INDIANA 46032 10431 WINDEMERE BLVD CHECK NUMBER: 244921
+,y_�oN CARMEL IN 46032 CHECK DATE: 05/05/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 5023990 84.49 OTHER EXPENSES
vC�Vi�C�-
:.hµi
�Cp
Reimbursement Expense Receipt
Reimbursement expenses are transactions that were conducted by a third-party whom
needs a reimbursement on behalf of the CN4YC organization Transactions such as CNffC
members paying for CMYC event materials would be one example of a reimbursement expense.
After completing this form,please submit it to the Council Clerk-Treasurer.
Expender:
Vendor(location of purchase): Cosfco
Date: : /c/, z-
Event/Activity
(if applicable): ��Mnl�/,;,•_, �St
Expense Account (see list of accounts):
Additional Description: �;,(`� C" tb
Expense Amount(do not include Sales Tax):
ReimburseeName:
Reimbursee Address (required): �p�31 w►� n_
v�,rYlere.. �� �irr►ul /N �(oo3Z
I verify to the best of my knowledge that this information is correct, and this purchase was
made n b alf of CTMYC and not for personal use or gain.
Expender Signature Date
Please submit this form to Clerk— Treasurer along with the purchase receipt.
Appendix 14—Page 1
i
wl
r,t
u397 liU,INDIANAPOLI^S
Gl0 MICNIGAN ROAD
iANRPOLIS,�-iN 46268
MEMBER #111451837,000
PREPAol
ID ,CARD #_313705329657875
� 137 ITUNES 100MP 94 49
MOM 09482:CPN%137 10:00
posite
XXXXXXXXXX) __ t SWLPEU
10/25!14-.13 17
;D09987�AP 517476
Resp AR
Tran'1ulF---!iz7oltofU5000
Merchant ID 99034711.:
APPROVEIJ PURCNASEn.Y `
AMOUNT. ..$84:99
0347' 409 OOOOOOQ075 0090
CHANGE00
COUPONS TENDERED ° 10.00
PRE- PAID
313705329657875' ACTIVE
3F)fiE�f�EWOxm*mxxx0ifOXEx�F�4�f�E�f�f�f�E�4��"`
NOTAL NUMBfR QF ITEMS SOLD"-"
CASHIER:. A�jam t atr REG# 9 }
77�ogfil 13-1 e7 0347 09 00 0 75
VOUCHER NO. WARRANT NO.
Emily Frank ALLOWED 20
IN SUM OF$
10431 Windemere Boulevard �
Carmel, IN 46032
$84.49
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT Board Members
pTO854`Year Receipt Mayor's Youth Council $84.49 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
Monday, May 01b
Director,Communi Relatio /Economic Development
%Di reI Title
lavI
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
10/25/14 Receipt $84.49
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