187921 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 355133 Page 1 of 1
e ONE CIVIC SQUARE AUDREY B KOSTRZEWA CHECK AMOUNT: $5.54
CARMEL, INDIANA 46032 2592 TURNING LEAF LANE
CARMEL IN 46032 CHECK NUMBER: 187921
CHECK DATE: 7/21/2410
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4342100 REIMB 5.54 POSTAGE
Carmel eClay
Parks &Recreat oh
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on recei t Line Budget Description Amount Purpose of Expense
6/23/2010 Carmel Post Office 1125 4342100 Postage 5.54 Certified mail
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $5.54
Employee Name (print) Audrey Kostrzewa
Address 2592 Turning Leaf. Lane
Check
payable to: City, St, Zip armel, I 46032
Signature: Approved by:
Date: 6/29/201 0 o
y� �g� Date:
�R 11 M
Business Services Division, Revised 7 -7 -08 J 0 2 2010
FILE: Shared�Administrative %FormslStaff Forms\Employee Exp Reimb Request
BY:
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.
355133 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
06123!10 Reimb Postage for certified mail $5.54
Total 5.54
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.
355133 Kostrzewa, Audrey Allowed 20
2592 Turning Leaf Lane
Carmel, IN 46032
In Sum of
5.54
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4342100 5.54 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
15 -Jul 2010
Signature
5.54 Accounts Payable Coordinator
Cost distribution ledger classification If Title
claim paid motor vehicle highway fund