186985 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
s ONE CIVIC SQUARE NIKEESHA PITTMAN
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK AMOUNT: $64.95
'y? INDIANAPOLIS IN 46208
CHECK NUMBER: 186985
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMS 45.95 TRAVEL FEES EXPENSE
1082 4239039 REIMB 4.00 GENERAL PROGRAM SUPPL
1082 4343007 REIMB 15.00 FIELD TRIPS
Carmel Clay
Parks &Recr ation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
6/1/2010 Eagle Creek 1082 -3 4343007 Bus Entry Fee $15.00 Field Trip
6/3/2010 Blockbuster Inc. 1082 -3 4239039 DVD "UP" $4.00 General Supplies
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $19.00
Employee Name (print) Nikeesha Pittman
;tea 4
Check Address 2713 Highland Place JUN 0 7 2010
payable to: City, St, Zip Iroianapolis, IN 46208
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a 1.ad •...e •ueoea n.e eeocoe
Signature: Approved by:
Date: 6/7/2010 Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrative \Forms\Statf FormslEmpioyee Exp Reimb Request
PMCRIBED BY STATE BOARD OF ACCOUNTS GENE04L -FOR4 No. w) 119067
MILEAGE CLA o TRA PE2 DIEfv�
c�C�l. �Q.lC1S'Nt}�
to 1
taovERxM7;rlTnt vN1r1 ON ACCOUNT OF APPROPRIATION NO- FOR K� 1T`i<
S1,tl MA�.A i
(OFfjCr, BOARD, DUAATiFrfr OR JHsTrru`r1ON)
FROM TO I 0EE IL
PA AUTO MEA.GE
DATE RE ADING NATURE OF BUSINESS DICES Q►3
�Q POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS
SPEEDOMETEB READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. i 51
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount cl a r ly aft r allowing all just credits
and that no k same has been paid.
Date
JUN Q 4 2010
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.
Terms
359461 Pittman, Nikeesha
Date Due
2713 Highland Place
Indianapolis, IN 46208
Invoice Invoice Description Amount
Number (or note attached invoice(s) or bill(s)) PO
Date 15.00
611110 Reimb Field trip 4.00
613110 Reimb General supplies 45.95
5127110 Reimb Milea a 5!4 5!27110
Total 64.95
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.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
64.95
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #rTITLE AMOUNT Board Members
Dept
1082 -3 reimb. 4343007 15.00 i hereby certify that the attached invoice(s), or
1082 -3 reimb. 4239039 4.00 bill(s) is (are) true and correct and that the
1081 -11 reimb. 4343000 45.95 materials or services itemized thereon for
which charge is made were ordered and
received except
17 -Jun 2010
Signature
64.95 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund