185220 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 363065 Page 1 of 1
ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $104.16
CARMEL, INDIANA 46032 C/O PARKS ESE
CHECK NUMBER: 185220
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOIG'E NUMBER AMOUNT DESCRIPTION
1081 4239039 REIMB 104.16 GENERAL PROGRAM SUPPL
Carmel o Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
r• j 0
`f�3903' P �s��eCe le �i».� 6 S��C
I
All receipts should be attached in the same order as listed above. c
No sales tax will be reimbursed. TOTAL: 10 r V
a
jam, MAY 0 5 2O10
Employee Name (print) ,J Q✓Y1 P. 5 I 1�3
Add ress BY:
Check
payable to: City, st, Zip
Signature: Approved by:
Date: 5 Date: �N�o
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, Where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
363065 Dowell, James Terms
14328 Banister Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
512/10 Reimb. Site celebration supplies 104.16
Mileage 211 411110
Total 104.16
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20,
Clerk- Treasurer
i
Voucher No. Warrant No.
363065 Dowell, James Allowed 20
14328 Banister Dr
Noblesville, IN 46060
In Sum of$
104.16
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #1T TI AMOUNT Board Members
Dept
1081 -7 Reimb. 4239039 104.16 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
5 -May 2010
Signature
104.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund