190341 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 361255 Page 1 of 1
0 ONE CIVIC SQUARE CARRIE KEAVENEY
CARMEL INDIANA 46032 13789 FIELDSHIRE TERRACE CHECK AMOUNT: $54.22
WESTFIELD IN 46074
�o CHECK NUMBER: 190341
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239039 REIMB 54.22 GENERAL PROGRAM SUPPL
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
9/3/2010 Tickle Your Fancy 1094 4239039 General Program Su lies $21.95 recognition plaque for intern
9/10/2010 Sub's Burgers and Ice Cream 1094 4239039 General Program Supplies 32.27 recognition lunch
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $54.22
Employee Name (print) Carrie Keaveney
Address 13789 Fieldshire Terrace
Check
payable to: City, St, Zip Carmel IN 46074
Signature: Approved b
�r
Date: 9121120 0 Date: l 2 p
Business Services Division, Revised 7 -7 -08 f1 Oq 17 FILE: Shared\Administrative\Forms \Staff Forms\Employee Exp Reimb Request U
sty 2 2010
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.
361255 Keaveney, Carrie Terms
13789 1=ieldshire Terrace
Westfield, In 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9121110 Reimb Supplies /plaque for intern recognition 54.22
Total 54.22
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
54.22
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 Reimb 4239039 54.22 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
23 -Sep 2010
���tii J V VII iz� J
Signature
54.22 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund