HomeMy WebLinkAbout196250 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1
ONE CIVIC SQUARE AMY BALDAUF CHECK AMOUNT: $29.42
CARMEL, INDIANA 46032 APT D LARK OR
CHECK NUMBER: 196250
CARMEL IN 46032
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 29.42 GENERAL PROGRAM SUPPL
Carmel P-, Clay
o 3> Parks &Recreati
Employee Expense Reimbursement Request
XF-Ow 10 5 R MN�� s s
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
3 6 -q C-ae oral r 2 9"] Z C u yes
All receipts should be attached in the same order as listed above. ZG 1 Ll
No sales tax will be reimbursed. TOTAL:
Employee Name (print) 'n
Address
Check
payable to: City, St, Zip N
signature: Approved by:
Date: Date:
-1�- -f
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\Forms\StaN FormslEmployee 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.
360484 Baldauf, Amy Terms
126 Lark Dr., Apt. D Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/16111 Relmb Program supplies 29.42
M i leag a 12/1/09 4127/10
Total 29.42
V 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.
360484 Baldauf, Amy Allowed 20
126 Lark Dr., Apt. D
Carmel, IN 46032
In Sum of
29.42
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1081 -8 reimb. 4239039 29.42 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
7 -Apr 2011
Signature
29.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund