HomeMy WebLinkAbout197328 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 365276 Page 1 of 1
ONE CIVIC SQUARE SYDNEY OTTO
CARMEL, INDIANA 46032 7815ISLAY ROAD CHECK AMOUNT: $29.90
INDIANAPOLIS IN 46217 CHECK NUMBER: 197328
CHECK DATE: 5111!2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 RETMB 29.90 GENERAL PROGRAM SUPPL
Carmel e Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
7 a i 5 4v(-- Qa'_ sin t
t,) S A (�yv� 1cq(O-N,� �a�q0 3°I �a P f I qt r DOLLS
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) Q dNo k`
Address
Check Del `1 APR 1 2011
payable to: city, St, zip
Y:. MAY 1 0
rSignatur j Approved by:
Date: 11 I Date: Z 1, 1
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelForms\staff 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.
Otto, Sydney Terms
7815 Islay Rd
Indianapolis, IN 46217
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4121111 Reimb Art class supplies 29.90
Total 29.90
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.
Otto, Sydney Allowed 20
7815 Islay Rd
Indianapolis, IN 46217
In Sum of
29.90
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1096 -42 Reimb 4239039 29.90 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
4 -May 2011
Signature
29.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I