245146 5 /13/2015 0/ � CITY OF CARMEL, INDIANA VENDOR: 366239
® ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: $**„ , ,47.26
x, q CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 245146
9M�roN�'� CHECK DATE: 05/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 47.26 TRAVEL FEES & EXPENSE
Carmel * Clay
Parrs&Recreation
Employee Expense Reimbursement Request 2b� bS� vim
Date of Fund Account Account
Receipt Vendor listed on recei t # Line# Bud et Descri 'on Amount Purpose of Expense
11311 Ql
4 5 c0ce
All receipts should be attached in the'same order as listed above.
No sales tax will be reimbursed. TOTAL: $: �r ✓
Employeen Name(print)
Address `���t o ellia 1,�� G rCA . APR 2 8 2015
Check o -
payable to: City, St,Zip N '('�(RQ,l��1
Signature:MEY'J- 2a 4Oj jQ f,_,,
I I rr Approved by:
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Date: `41 1 -6 C 15 Date: q-01--m
Revised 3-2-07 by Business Services;
Shared/Forms and TemplateslBusiness Service Forms/Employee Exp Reimb Request 2007-3
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`I® INDIANA o �n p f t
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.
366239 Haddock, Monica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/16/15 Reimb Travel expenses for 2015 OST Summit $ 40.15
Mileage 2/5-4/5/15
Total $ 40.15
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
120
Clerk-Treasurer
Voucher No. Warrant No.
366239 Haddock, Monica i Allowed 20
In"Sum of$
$ 40.15
1
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ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ -0 1-8' I hereby certify that the attached invoice(s), or
I' 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
May 7, 2015
I
1P
Signature
$ 40.15 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund yy
11
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