186846 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
0 ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK AMOUNT: $94.87
INDIANAPOLIS IN 46220
a CHECK NUMBER: 186846
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 94.87 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
G G2 osalo e 4 S r I+ ANn6s
U 15 l h a, l 4 t o% a Io% -`l C) 3 gcj 3l r 6 scp r r
�OEaloi oS9 tr 4 00
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: C�
Employee Name (print) VV\ I JUN zalo
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Address J I C)14' y tP ��1��
Check
to Y P �(1 L 1
p ayable Cit St, Zip t G�(1 4 t�� C,[ �jf p� G
Signature: I Approved by:
Date: l Q Date
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministralive lForms\Staff FormslEmployee 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.
358411 Hammons, Jennifer Terms
634 Northview Ave Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/9110 Reimb. Walmart/Dollar Tree Camp supplies 94.87
Total 94.87
I 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.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
94.87
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1082 -8 Reimb. 4239039 94.87 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
17 -Jun 2010
Signature
94.87 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1