HomeMy WebLinkAbout189864 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 361255 Page 1 of 1
h ONE CIVIC SQUARE CARRIE KEAVENEY
ro CARMEL, INDIANA 46032 13789 FIELDSHIRE TERRACE CHECK AMOUNT: $15.25
s a:Eo WESTFIELDIN 46074 CHECK NUMBER: 189864
CHECK DATE: 9/14/2010
DEPARTMEN AC COUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239039 REIMB 15.25 GENERAL PROGRAM SUPPL
Carme
Parks &Recre
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line nn Budget Description Amount Purpose of Expense
X39039 l9za -"c P, rar" 31plir3
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
5' a
Employee Name (print) a f r; z rzaQ o-'1c
Address 1 9 i a s AUG 4 2010
Check
payable to: City, St, Zip Char me I f N o`i
Signature: (f A r Approved b
Date: Ia( 10 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelForms\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.
361255 Keaveney, Carrie Terms
13789 Fieldshire Terrace
Westfield, In 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
$!18110 Reimb Lunch for Leads 15.25
Total 15.25
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.
361255 Keaveney, Carrie Allowed 20
13789 Fieldshire Terrace
Westfield, In 46074
In Sum of
15.25
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1094 Reimb 4239039 15.25 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
15.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund