185167 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
CARMEL, INDIANA 46032 5130 PRIMROSE AVE CHECK AMOUNT: $159.42
INDIANAPOLIS IN 46205
CHECK NUMBER: 185167
CHECK DATE: 5/1112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 159.42 TRAVEL FEES EXPENSE
Carrel i Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
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14 lav Ar�c>`ms r� 11 .I 7,9 5
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (prinq -�6�� ��\�dLm�Ly✓'\
t
Address yVV
Check
payable to: City, St, Zip ,�,l,�� p \�5 LD �L
Signature: Approved by: "k VV h'
Date: Date: Z-
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\Forms\Staff Forms\Employee Exp Reimb Request
Carrel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
U I NV- V116- 013000
All receipts should be attached in the same order as listed above. I
No sales tax will be reimbursed. TOTAL: 1 1�
Employee Name (print)
Check Address
payable to: City, St, Zip jla Vl a I l� �nzbs
Signature: C Approved by.
Date Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelForms\Staff Forms\Employee Exp Reimb Request
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/21/10 Reimb. Natl Afterschool Assoc Conference 159.42
Mileage 2/22 3/29/10
Total 159.42
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.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
159.42
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 Reimb. 4343000 159.42 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
v
5 -May 2010
Signature
159.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund