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161699 07/23/2008 *f CITY OF CARMEL, INDIANA VENDOR: 00350221 Page 1 of 1 ONE CIVIC SQUARE LINDA ACOSTA CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $20.92 CHECK NUMBER: 161699 CHECK DATE: 7/23/2008 DE PARTME NT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DE SCRIPTIO N 1046 4239040 FOOD BEVERAGES '1046 4343000 12.12 TRAVEL FEES EXPENSE I I car e� U 0a Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account account Receipt Vendor listed on receipt Line Budget Description Amount Purp ose of Expense \01A6 I L f 5 x f l receipts should be attached in the same order as listed above sales tax will be reimbursed. TOTAL: i c Employees Name (print) Address JUL ©8 2008 Check Y City st zip e payable able to: Signature: '.tom Approved by: Date: Date'. Business Services Division, Revised 3 -2 -07 FILE: SharedlAdministrative \Forms\Staff Forms%Employee Exp Reimb Request v, PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986) MILEAGE CLAIM 3C� c T.— T O (GOVERNMENTAL. UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) FROM SPEEDOMETER DATE TO READING AUTO M NATURE OF BUSINESS ILEAGE_ POINT START FINISH TRAVELED .�O POINT PER MILE 7l� QJ� i I JUL 0 8 n I�S y AUTO LICENSE NO. TOTALS J SPEEDOMETER READING columns are to be used only when distance between points be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits end that no part of the same has been paid. Date 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. 350221 Acosta, Linda Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/2/08 reimb. Lunch at Excel class 8.80 7/7/08 reimb. Mileage 5/5/08- 5/15/ -08 12.12 Total 20.92 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. 350221 Acosta, Linda Allowed 20 In Sum of 20.92 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT#fTlTLE AMOUNT Board Members Dept 1046 reimb. 4239040 8.80 1 hereby certify that the attached invoice(s), or 1046 reimb. 4343000 12.12 bill(s) is (are) true and correct and that the I materials or services itemized thereon for which charge is made were ordered and received except 16 -Jul 2008 Signature 20.92 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund