HomeMy WebLinkAbout260048 06/28/16 '4�/`C�H,yf! CITY OF CARMEL, INDIANA VENDOR: 357976
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ONE CIVIC SQUARE BENJAMIN JOHNSON CHECK AMOUNT: $*******267 84*
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CARMEL, INDIANA 46032 11182 HARRISTON DRIVE CHECK NUMBER: 260048
9M,iroN. FISHERS IN 46037 CHECK DATE: 06/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIM 267.84 TRAVEL FEES & EXPENSE
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Voucher No. Warrant No.
357976 Johnson, Ben J Allowed 20
11182 Harriston Drive
Fishers, IN 46037
In Sum of$
$ 267.84
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#orBoard Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1081-99 Reimb 4343000 $ 199.81 1 hereby certify that the attached invoice(s), or
1081-99 Reimb 4343000 $ 68.03 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
June 21, 2016
Signature
$ 267.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Carmel o Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above. rq9
No sales tax will be reimbursed. TOTAL: - 1
Employee Name(print) ,��� j / �
Address
Check S'Zr' `h e JUN 2,0 2016
payable to: City, St, Zip if,) q(003-7
BY:
Signature: // Approved by:
Date: (p ��— Date:
Business Services Division,Revised 7-7-08
FILE: SharedWdministrative\Forms\Staff Forms\Employee Exp Reimb Request
Carmelo Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print)
Address ���Ve��
Check (�� � /r- JUN2 0 �t;16
payable to: City, St, Zip �{ si46 -S /� `1�(03�
Signature: Approved by: BY:
Date: (9-A T4 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request