181130 01/13/2010 7 7 CITY OF CARMEL, INDIANA VENDOR: 357435 Page 1 of 1
ONE CIVIC SQUARE ANDREW BURNETT CHECK AMOUNT: $10.69
t ;a CARMEL, INDIANA 46032 9215 N. PARK AVENUE
o M INDIANAPOLIS IN 46240 CHECK NUMBER: 181130
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4237000 10.69 REPAIR PARTS
Car. i el o (Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of
Receipt Vendor listed on receipt Fund Department Account Line Account Description Amount Purpose of Expense
ja E s-t- Uac_u u if 4 31000 p,i./ a m-s 1 Vc,(0./01 PP pairRc,+
All receipts should be attached in the same order as listed above.
TOTAL 1 J d, i 1
Name (print) A 1CJ'su,J 13 Uc'f\e.
Check Address s 15 Wo r-\ 'poJ Avc1\
payable to:
City, St, Zip _bolt
Signature it tiI Date: t c 9 a 6)v 1 7
Approved by: U
Revised 3 -2 -07 by Business Services L DEC 2 2 2009 L
Y: 1
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BEST! Vacuum Center
Service AFTER the sale!
622 South Range Line Road
CARMEL, INDIANA 46032
(317) 844 -5501
CU SSTOMER'S ORDER NO. PHONE DATE
E
NAM r p
ADDRESS
SOLD BY CASH 6HAFr
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2.
g am
DEC__ 8Y- 2009_x
TAX
RECEIVED BY
TOTAL
J L/91,
29506 All warranty claims must be ac-
companied by this bill. All sales final.
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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.
357435 Burnett, Andrew Terms
9215 North Park Avenue Date Due
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/14/09 reimb. Vacuum repair parts 10.69
Total 10.69
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.
357435 Burnett, Andrew Allowed 20
9215 North Park Avenue
Indianapolis, IN 46240
i In Sum of
10.69
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1125 reimb. 4237000 10.69 I 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
7 -Jan 2010
Signature
10.69 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund