188742 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 364563 Page 1 of 1
0 ONE CIVIC SQUARE BRANDON BROWN CHECK AMOUNT: $26.00
CARMEL, INDIANA 46032 9540 BENCHMARK DR. APT C
INDIANAPOLIS IN 46240 CHECK NUMBER: 188742
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 REIMB 26.00 GENERAL PROGRAM SUPPL
Carm 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
IMjia a39 03 9 2 6 D4 ,Ke, -s 1_
Cf A M"k-
All receipts should be attached in the same order as listed above. O l
No sales tax will be reimbursed. TOTAL: V
Employee Name (print) �Q1220Y7
Address ,��rnlCx .f
AUG' 0 20
Check
payable to: City, St, ziP cl� BY
Signature: G'l Approved by:
Date: 7� Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministralivelForms \Staff FormslEmployee Exp Reimb Request
.Carmel Clay Parks
and Recreati
Memo
To: Paula Schlemmer
From: Cyndi Canda
CC: Ben Johnson
Date: 813/2010
Re: Brandon Brown check request
I have submitted a check request made payable to Brandon Brown in the amount of $26.00 for a
damaged library book. Brandon is a seasonal summer employee who allowed us to use his library
pass to the Nora public library to check out books for our Preschool Palace summer camp. The book
had water damage that was caused by one of the preschool campers. Brandon has paid the amount in
full and I am requesting that he be reimbursed the full amount. The supporting paperwork has been
submitted to Ben Johnson.
1
Hotmail bpbl2 @hotmail.com Windows Live Page 1 of 1
Tndianapolis- Marion County Public Library
Thank you for your payment.
Library Cara: 21978061787265
Amount of Payment: $26.00
Card Number: *
Expires: 05/11
Payment Date /Time: July 30, 2010, 10:47 am
Transaction ID: VUGA5D1422FB
i
If you have any questions about your payment,
please send an e -mail to payments @imcpl.org
P.O. Box 6134
2450 N. Meridian Street
Indianapolis, IN 46206 -6134
(317) 275 -4005
http //b1126w.blul26.mail.live.com/ mail /InboxLight.aspx ?n= 515481861 7/31 /2010
F,. /f �i L f F i %i }i` i C
Indianapolis Marion County Public Library
Thank you for your payment.
http: //bl 126w.blu l 26.mail. live. com /mail/InboxLight.aspx ?FolderlD= 00000000 -0000- 0000... 7/31/2010
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
Brown, Brandon
9540 Benchmark Dr., Apt. C
Indianapolis, IN 46240
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s))
Date Number PO 26.00
7/29110 Reimb. Reimbursement for damaged library book
Total 26.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Brown, Brandon Allowed 20
9540 Benchmark Dr., Apt. C
Indianapolis, IN 46240
(Pleas& In Sum of
26.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITL1 AMOUNT Board Members
Dept
1082 -2 Reimb. 4239039 26.00 1 hereby certify that the attached invoice(s), or
bitl(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
12 -Aug 2010
Signature
26.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund