184311 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 360880 Page 1 of 1
ONE CIVIC SQUARE SHAWN HART
CARMEL, INDIANA 46032 1302 SPRUCE DRIVE CHECK AMOUNT: $18.78
CARMEL IN 46033
CHECK NUMBER: 184311
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4238000 REIMB 18.78 SMALL TOOLS MINOR E
Carm eay
Parks &Recr�ea
s.
Employee Expense Reimbursement Request
Date of
Receipt Vendor listed on receipt Fund Department Account Line Account Description Amount Purpose of Ex ense I,
ia
All receipts should be attached in the same order as listed above.
TOTAL
E 7� P
Name (print) LLW k
Check Address 1Y,02
payable to:
City, St, Zip
Signature Date:
Approved by: Date: J
Revised 3 -2 -07 by Business Services
..t
MAR 2010 61"
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
Terms
360880 Hart, Shawn
Date Due
Carmel, IN 46033
;3112/10 ice RE Description Amount
or note attached invoices) or bill(s)} PO
te 18.78
drill bits from Low
Total 18.78
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No,
360880 Hart, Shawn Allowed 20
In Sum of$
18.78
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 reimb. 4238000 18.78 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
8-Apr 2010
Signature
18.78 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund