186756 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
Q� CHECK AMOUNT: $166.18
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
INDIANAPOLIS IN 46205 CHECK NUMBER: 186756
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 166.18 GENERAL PROGRAM SUPPL
Carmel Clay
Parks &Recreati
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
tp I 0 Z3 90M Q v a 1 S i Cum
W/lo ?T�Zj)Q K S CS Z- Z e Icy 4701 Ca
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL.: h
Employee Name (print)
Address �Y1(} JUN 1 2010
Check A r
payable to: City, St, Zip I N v Le Z6
Signature: "a AW Approved by:
Date: Date:
Business Services Division, Revised 7 -7 -48
FILE: Shared \Administrative\Forms\staff Forms\Employee Ezp Reimb Request
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
AI sv I CS W
All should be attached in the same order as listed above.
sales tax will be reimbursed. TOTAL:
Employee Name (print)
rr�� JUN 0 7 2010
Address L V m o &je
Check
payable to: City, St, Zip V&C11/0 0() f 5 I )A/ �V�
Signature: Approved by:
rf �j r �O
Date: lX l I D Date:
Business Services Division, Revised 7 -7 -08
FILE. Shared\Administrative\Forms \Staff Forms\Employee Exp Reimb Request
j I 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
613110 Reimb. Hobby Lobby Camp supplies 44.48
6110110 Reimb. Goodwill /Prizm Art Camp supplies 121.70
Mileage 2122 3/29/10
Total 166.18
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
166.18
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1082 -4 Reimb. 4239039 44.48 1 hereby certify that the attached invoice(s), or
1082 -4 Reimb. 4239039 121.70 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
17 -Jun 2010
Signature
166.18 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund