185833 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 355133 Page 1 of 1
ONE CIVIC SQUARE AUDREY B KOSTRZEWA CHECK AMOUNT: $53.50
CARMEL, INDIANA 46032 2592 TURNING LEAF LANE
+r'�r• CARMEL IN 46032
row CHECK NUMBER: 185833
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4341991 REIMS 53.50 MARKETING PROMOTION
Carmel 0 Clay
Parks& Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
5/14/2010 Indianapolis Newspapers, Inc. 1091 4341991 Marketing Promotions $53.50 Newspaper ad for special event
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $53.50 D 0
Employee Name (print) Audrey Kostrzewa
MAY X0;0
Check
Address 2592 Turning Leaf Lane BY
....e...........
payable to: City, St, Zip Carmel, IN 40632
Signature: Approved by:
Date: 5/14/2010 Date:
Business Services Division, Revised 7 -7 -08
FILE. Shared \Administrative\Forms%Staff FcrmslEmployee Exp Reimb Request
MAY -14 -2010 10:35A FROM:THE INDIANAPOLIS STA 3174447373 TD:95714136 P.1'1
3/7
ZJ ).347
INDIANAPOLIS NEWSPAPERS, INC. FAX PROOF
Ad limber: 5651529
A
Customer: CARMEL CLAY PARKS RECREATION Contact: SERRA GARSKE Phone: 3175734020
Price: 53.50
Section: CL Class: 251
Size: 1 H 11 Start Date: 05/20/2010 End Date: 05/22/20100r-
dered: 7 Times
Class: 251 Printed 6y: C126 05/14/2010
Signature of Approval: Date:
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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.
Kostrzewa, Audrey Terms
2592 Turning Leaf Lane Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
05/14/10 Reimb Nevi a er ad forspecial event $53.50
Total 53.50
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,
Kostrzewa, Audrey Allowed 20
2592 Turning Leaf Lane
Carmel, IN 46032
In Sum of
53.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#fTlTLE AMOUNT Board Members
Dept
1091 Reimb 4341991 53.50 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
53.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund