324306 04/25/18 4
p''• CITY OF CARMEL, INDIANA VENDOR: 372388
.;_ b �i•: ONE CIVIC SQUARE NICOLE AGNEW CHECK AMOUNT: $********25.83*
?Q CARMEL, INDIANA 46032 3135 E.71ST ST. CHECK NUMBER: 324306
INDIANAPOLIS IN 46220 CHECK DATE: 04/25/18
. JON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 25.83 TRAVEL FEES & EXPENSE
z. i
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 1�3C�0 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Agnew, Nicole (� Payee
3135 E 71st St
Indianapolis, IN 46220 In Sum of$ Purchase Order#
Agnew, Nicole Terms
$ 25.83 3135 E 71st St Date Due
Indianapolis, IN 46220
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#ornvolce Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 Reimb 4343000 $ 25.83 Board Members 4/16/18 Reimb Travel Expenses Indiana Summit 2018 $ 25.83
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
$ 25.83 Total $ 25.83
April 18,2018
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature -,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Carmel • Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description
!'� I rt' Amount Purpose
of Expense
O k� 7-. C� & nt tos%-°R FooA
S
�! �b S�o,�bv c,1E-s i�8►-°1°t 434 000 -c`°`�'e`,G „sus L . Ella ✓ f:-0
--n Civ5nc
tout
L�In •
2.d1b
All receipts should be attached in the same order as listed above. 2 s.
Nlo sates tax will be reimbursed. TOTAL;
Employee Name (print)
Address 3SN 3 S F_ -1 k - ST
Check
payable to: City, St,Zip M'V)"k. V-%rAc'a Ii S IN 14(o2.7- 0
Signature: Approved by:
Date: "T'1 1 I g Date: l
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Thahl om-f 0 .d"11,19 v;i"til I -
-- P.F. Ct-+ar7g's China Bistro. €
#8400
317 974 5747
'DOB-i-0411012018-
Hyatt Regency Indianapolis
i Server Timothy" 04/10/2018 One South Capitol Avenue
�'. 3 12:11 PM 2 20010 Indianapolis, Indiana, USA, 46204
I Table 21/2 / Tel: +1 317 632 1234
Thank you for dining with
? Starbucks
P.F. Chang's China Bistro. I SALE C
#8400 6115795 GeleenM t
317 974 5747 M/C 3145735
Card #XXXXXXXXXXXX9866 C 1-i K 12524
Server Timothy
04/10/2018 ; Magnetic card present: AGNEW/NICOLE B 4/10/2018 12:51 PM
12:00 PM- I Card Entry Method: S . ------------------------------------
Table ; 1/2 i 1 G Caffee Mocha 4.55
Guests 10 #2 0 0 1 0Approval: 121144
*x**********9866
j. �
Mastercard:125106
14.95 Amount-. $17.39 Credit Authorization 4.96
Ginger Chicken* 1,00
Sub Cul Fried Rice i
� �
+ Tip: Food Sales $4.55
15.95 *Tax $0.41
Subtoti 1 1 ,44 - Total.. TO F'ia'yrnerft $4 . 00
Tax Char-ioe true $0 . 00
17.39 + f Mastercard $4.96
Total I agree to pay the above ************9866
Bal ���� C��� 17 . 3'3 total amount:according _to the
�` -: 9327/PF POS Masterc
card °issuer =agreement.
----------/ / 018 12 51 PM---------
Check Closed I
X 4102 :
I .F. Changs Rewards Members: 1 _ � �
Don't forget to give your phone
Lumber to your server to earn * ** ***************** *******************
P.F. Chang's Rewards Members:
points for today's meal . Don't forget to give your phone
*** number to your server to earn
Gratuity Not Includes! ,
points for 4today's meal
Gratuity Nat Included
' Thank You!
1 -