185633 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 361411 Page 1 of 1
b ONE CIVIC SQUARE CRYSTAL ALLEN CHECK AMOUNT: $5.77
+o CARMEL, INDIANA 46032 2411 CUMBERLAN STREET
P 0 BOX 468 CHECK NUMBER: 185633
DUBLIN IN 47335
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 5.77 GENERAL PROGRAM SUPPL
4L
Carmel 0 Cla
air s &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
5/3/2010 Wal Mart 1096.000 32.4239039 General Program S upplies Key Tags for Mothers Day Class
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) Crystal Allen
Address PO Box 468
Check
payable to: City, St, Zip Dublin I /J IV I 47
Signature: j(l� Approved by:
Date: 5/4/2010 Date: lQ U
Business Services Division, Revised 7 -7 -08
FILE: SharedWdministrative %FormslStaff 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.
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
513110 Reimb. program supplies 5.77
Total 5.77
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
5.77
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1096 -32 Reimb. 4239039 5.77 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
20 -May 2010
Signature
5.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1