HomeMy WebLinkAbout245196 5 /13/2015 �i ,� CITY OF CARMEL, INDIANA VENDOR: 369356 ,
® ONE CIVIC SQUARE KIMBERLY MATTERS CHECK AMOUNT: $*****#,,,,40.00
f. _� CARMEL, INDIANA 46032 C/O PARKS DEPARTMENT CHECK NUMBER: 245196
',;ETON CHECK DATE:. 05/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4357004 40.00 EXTERNAL INSTRUCT FEE
Carmel • Clay
FBYY
2 8 2015 Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
All receipts should be attached in the same order as listed above. p
No sales tax will be reimbursed TOTAL:
Employee Name(print) ( N !
Address -
Check �(^
payable to: City, St,Zip V,
Signature: a Approved by:
i
Date: C Date: y�2711
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Order#47678
https://hes-ssequip.healthways.com
Date:Wednesday,April 22,2015
Billing Information:
Name: Kimberly Matters
Phone:
Address: 8121 lincoln blvd
Indianapolis,Indiana 46240
United States
Payment method:CRESecure
Product(s)
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$40.00 1 $40.00
Classic-2015
Sub-total:$40.00
Tax:$0.00
Order total:$40.00
;
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Classic - 2015
f 1-
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Course Name
Kimberly R Matters Kymberli D Nix
Participant Name(please print) Course Trainer
4/24/2015 North Manchester/ IN
- ��# -- ,- h Program Date Program Location (City/State)
Certifications;_ Course#t � .Fr, '.CECs
ACE'-t , --CEP69724 : 0 20 Z ,d .
AEA �} -3 '446'194 _ 1 25 4
7' = 2s Strauss-Peabody Aquatic and Fitness Center
AFAR ' 11<<203 -",a<X2400z
_ r r- - g,, Program Facility Name
�. ACSIVI 664481 .'� a,.: 250 - g Y
ye W1ways, Iv c'.
________ CAl\no.Aiz.t.
Provider Name Provider Signature
This course has been approved by AFAA for continuing education units,but was not developed by AFAA.Therefore it does not count as an AFAA course which is required for recertification
•y
4246-100-15928
SSFPNAT-385 9.11
Page 1 of 1
Order Number:47678
Course Name: Classic-2015
Start Date:4/24/2015
Start Time: 10:00 AM
Length: 02:00:00
Venue Name: Strauss-Peabody Aquatic and Fitness Center
Address: 902 N. Market St
Instructor Name: Kymberli Nix
Trainer Email: kymberlinix(a).gmail.com
Order-Summary
Name Price Quantity Total
Classic - 2015 $40.00 1 $40.00
Sub-Total: $40.00
Tax: $0.00
Order Total: $40.00
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This email contains confidential and proprietary information and is not to be used or disclosed to anyone other than the named recipient of this
email,and is to be used only for the intended purpose of this communication.
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APR 28 ;
https://mail.aol.com/webmail-std/en-us/suite 4/22/2015
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.
Matters, Kimberly Terms
8121 Lincoln Blvd
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/24/15 Reimb Certification $ 40.00
Total' $ 40.00
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.
Matters, Kimberly Allowed 20
81,21 Lincoln Blvd
Indianapolis, IN 46240
f In Sum of$
1
$ 40.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
I
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept# f
1091 Reimb 4357004 $ 40.00 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
May 7, 2015
'PAW0WVUA)l
Signature
$ 40.00 ,; Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund S