185132 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 361411 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL ALLEN CHECK AMOUNT: $132.33
CARMEL, INDIANA 46032 2411 CUMBERLAN STREET
4 .off `o P 0 BOX 468 CHECK NUMBER: 185132
DUBLIN IN 47335
CHECK DATE: 5/1112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 REIMB 132.33 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM NO. 101 (1928)
MILEAGE CLAIM
cxws�w
TO Ll
GOVERNMENTAL UNITI
ON ACCOUNT OF APPROPRIATION NO FOR
(OFFICE, BOARD. DEPARTMENT OR INSTITUTION)
DATE FROM TO I §PIDOMETER AUTO MILEAGE
READING NATURE OF BUSINESS MILES SCE
POINT POINT START FINISH TRAVELED PER NULE
L o a Lb 1; n >nd�a ;6a O
Del :a�OIO 1oC1Ttt l zl 7 av
I
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certi that the foregoing account is just and correct, that the amount claimed is legally due, after aliow ng all just credits
and that no a the same has been paid.
'Date 1 li�An
APR 2 6 2010
l0� �3�i3000
Bye......
Carmel Clay
Parrs &Recreation 4111 41 141 1 D
Employee Expense Reimbursement Request S. U. EXF_CU vE OtNaDPM0
vvt
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
4/12/2010 Memorial Union Market 10q 1 y3430 $4.37 Breakfast at IUEDP
4/12/2010 Buffalouies at the Gables [091 x-134 6 1 CCO 8.01 Lunch at IUEDP
4/12/2010 Qdoba Mexican Grill 43H _SWC) 6.84 Dinner at IUEDP
4/13/2010 Memorial Union Market 1,091 W- 3H SO00 2.94 Breakfast at IUEDP
4/13/2010 Village Deli M L A3 y 3 000 4.23 Lunch at IUEDP
4/14/2010 Memorial Union Market 1091 43y3000 2.94 Breakfast at IUEDP
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $29.33
Employee Name (print) Crystal Allen i
Address PO Box 468
Check
-payable to: City, St, Zip Dublin, IN 47335 BY: ...................a..
Signature: Approved by:
Date: 4/15/2010 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\Forms\staff Forms\Employee Exp Reimb Request
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ACCOUNTS PAYABLE VOUCHER
w CITY OF CARMEL
An invoice of biH 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.
361411 Allen, Crystal Date Due
P.O. Box 468
Dublin, IN 47335
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/19/10 Reimb. Mileage 4/11 4/14/10 103.00
4/15/10 Reimb. Conference expenses 29.33
Total 132.33
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Allowed 20
361411 Allen, Crystal
P.O. Box 468
Dublin, IN 47335 In Sum of
132.33
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1091 Reimb. 4343000 103.00 1 hereby certify that the attached invoice(s), or
1091 Reimb. 4343000 29.33 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
J received except
f
u
5 -May 2010
'P&hk1n1"M0
Signature
132.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund