189816 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK AMOUNT: $12.51
INDIANAPOLIS IN 46220 CHECK NUMBER: 189816
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 12.51 GENERAL PROGRAM SUPPL
Carmel o Clay
Parks &Recreate ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
Y 4 1 o c�( \r
All receipts should be attached in the same order as listed above. j
No sales tax will be reimbursed. TOTAL:
Employee Name (print) �A rr oy��
Address L4 3 G K�j�Vl� yJ
Check
payable to: City, St, Zip lid C.n�G �i5 t �D a pZC, BY:—
Signature: Approved by:
Date: Date: L
Business Services Division, Revised 7 -7 -48
FILE: Shared \Administrative\Forms\Staff Forms\Employee 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 Harnmons, 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
8 {30110 Reimb. Program supplies 12.51
Total 12.51
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
i
Voucher No. Warrant No,
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
92.51
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE= NO. ACCT /TITLE AMOUNT Board Members
Dept
1081 -10 Reimb. 4239039 12.51 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
9 -Sep 2010
Signature
12.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund