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305863 12/12/16
9t�w C,�~� �; L! CITY OF CARMEL, INDIANA VENDOR: 369494 CHECK AMOUNT: $*R Y i«■*R 80.15' ONE CIVIC SQUARE JANE REIMAN :, ,�+` CARMEL, INDIANA 46032 221 E MAIN ST CHECK NUMBER: 305863 y APT CHECK DATE: 12/12/16 tr w CARMEL IN 46032 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1203 4359003 RECEIPT 80.15 FESTIVAL COMMUNITY EV 0 0 > 2 > O § \ 2 z 2 \ ° 0 > / m 2 m q c z O 06 06 m2 0 % m / § ® / m ] O \ - T $ © 3 k / [C7D� 0k �CL > T. �E \ > n O \ / / q � | . & � \ 2 E f / £ ƒ 0 f / E o FL / E 0 ( F $ § m CL x 2 ? v $ g m f R - a 2 E ® I f 2 { , J v 'o O g . § - CD I § \ k § / a £ 0cr a - w a :,4 $ I \ - E t § , k G § 2 ° I f } / a , - , Q § # ƒ %(D = my - i ) m \ E _ 9)E o _ m � D / \$ / \ 0 , n � X -n ° 0 w k(D o m 0 0 ƒ \ \ ° ( G % $ 7 k %E § k g | e< f E 2 D 0 > > �f 2 § § / # 2 n $ / j E \ \ 0 E ¥ £ % j / E CD % ¢ & & / } n \ 8 m $ 2 m k > / - o / (D § z a � k EMPLOYEE REIMBURSEMENT Sales tax is not reimbursable NAME: �aY1�- %wvxyN ADDRESS: TOTAL$AMOUNT OF=SION THIS PAGE• • • PURPOSE OF EXPENSE � Use separate sheet for different purposes or events, as account coding may vary AFFIX ORIGINAL RECEIPT(S)BELOW OR ATTACH,IF RECEIPT IS FULL PAGE C.ckb ,tii,jUE, AUTHENTIC & ALWAYS AFFORDABLt WWW,WORLDMARKET .COM 221 CKOT 9787 92 00`) CADENCE RECT NAT M 000000525759 1 @ 24.99 A 24.99 CADENCE RECT NAT M 000000525759 1 @ 24.99 A 24.99 CADENCE RECT NAT M 000000525759 1 @ 24 .99 A 24.99 ** WRAP-POLY-CLEAR 000000025117 2 @ 2.59 A 5.18 O.00X TAX RATE .00 TOTAL. 80. 15 DISC 80. 15 ACCT#: ************2477 EXPDT: XX/XX AUTH#: 01765R Sequence #2322088675 CHANGE .00 ,,OUPON SAVINGS .00 IIII[p SAVINGS .00 It)TAL SAVINGS .00 THANK YOU FOR SHOPPING AT OUR CARMEL STORE (317) 706-0400 Illillllllll 111111 IIII IIII II IIIIIIIIIIVIII 2111-7160-0929-7870-0513-58 NOVEMBER 17, 2016 1 :58 PM