158282 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1
ONE CIVIC SQUARE AMY BALDAUF
s; to CARMEL, INDIANA 46032 CHECK AMOUNT: $383.57
9441 BENCHMARK DR APT 6
INDIANAPOLIS IN 46240 CHECK NUMBER: 158282
CHECK DATE: 4/15/2008
ti
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239038 134.95 AWARDS PRIZES
1046 4343000 248.62 TRAVEL FEES EXPENSE
r
Carmel 0 clay IV�1D
Parks &Recreation APR 4 2008
Employee Expense Reimbursement Request BY:
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
3/12/2008 Gior io's 9.50 +1.50 ti =$11 Food
3!12!2008 Lulu Bait Shop 20.90 3.31 ti $24.21 cob' Food
3113/2008 Bravo Italiano Ristorante 8.95 +1.50= $10.45 d Food
3/13/2008 Cold Stone Creame ry 6.07 1.00 ti $7.07 Food
3/14/2008 Bubba Gump Shrimp Cc 18.99 2.85 $21.84 Food
3/14/2008 Flavors of ItalyV v Is" r v 14,90 r Food
3/14/2008 Cold Stone Crea 5.09 Food
p i
3/15/2008 Travel Hospitality Services 6.00 .3 Food
3/15/2008 Starbucks I 6.79 ,a' Food I
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 1072
Employee Name (print) Amy Baldauf
Address 9441 Benchmark Drive, Apt B
Check
payable to: City, St, Zip Indianapolis, IN 46240
Signature: Approved by:
Date: 3/20/2008 Date: V
.vices Division. Revised 3 -2 -07
"lministrativelFormslStaf( Forms\Employee Exp Reimb Request
ra
ti.
Carrel o Clay FID
Parks &Recreati ®n Zoos
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt K NIC Line Budget Description Amount Purpose of Expense
3 21 23 0 3 z emu �K� Yd �Gf
i Ix
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employeen Name (print) &k(
Check Address` C�y I 9bcnc '1r -nLD�
payable to: City, St, Zip
Signature: Approved by:
1
Date: Date:
Business Services Division, Revised 3 -2 -07
FILE: Shared\Administrative \Forms \Staff Forms\Employee Exp Reimb Request
V%
Carmel o Clay RECEIVED
Parks &Recreation APR 4 2008
Employee Expense Reimbursement Request BY:
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
l
3/12/2008 Gior io's 9.50 +1.50 ti =$11 Food
3/12/2008 Lulu's Bait Shop 20.90 3.31 ti $24.21 Food
3/13/2008 Bravo Italiano Ristorante 8.95 +1.50= $10.45 Food
3/13/2008 Cold Stone Creamery 6.07 1.00 ti =$7.07 Food
3/14/2008 Bubba Gump Shrimp Co 17 18.99 2.85 $21.84 Food
3/14/2008 Flavors of Italy 14.90 Food
3/14/2008 Cold Stone Creamery 5.09 Food
3/15/2008 Travel Hospitality Services 6.00 Food
3/15/2008 Starbucks 6.79 Food
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 107.39
Employee Name (print) Amy Baldauf
Address 9441 Benchmark Drive, Apt B
Check
payable to: City, St, Zip Indianapolis, IN 46240
Signature: Approved by:
Date: 3/20/2008 Date: o 3,0
Business Services Division, Revised 3 -2 -07
FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request
po
JCPenney
v S
o f
Afterschool
AMY
BALDA U F
CARMEL IN
W -'T -F
1�
I,
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM HO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIA'T'ION NO, F
(OFFICE, BOARD, DEPARTMENT OR INSTrMnON)
SPEEDOMETER. $G
DATE FROM TO READING O
NATURE OF BUSINESS bULES Q J E a
0� POINT POINT START FINISH TRAVELED PER MILE
Q
�2 s no
b. Z- S' O
2 ,S
ar 3 5rno
3 w
r 5 1
NkcLr t4 M o .ow
W
Mar LP 1 5' I)Kq FIL ti
n 9 m en )Z() VU
Ma c 7
ar 101 5
r in I S rn o wt-on 1 1Z UV\J
on b
Ca 7 NA r
Mor Q Man 6n t2io
n .5
a
Zv.. S
Y
AUTO LICENSE NO. TOTALS 7 V
I
SPEEDOMETER READING columns are to be used only when distance between -poirits cannot 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,
eud that no part of the same h een pa
D a "I te 0 1 U
PRESCRIBED BY STATE BOARD OF ACCOUNTS I I E° ED GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM f APR 4 2008
TO kuk
(GOVERNMENTAL' UNTT) BY:
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
PEEDOMETER. I
DATE FROM TO READING MI O MILEAGE
S
NATURE OF BUSINESS I`
POINT POINT START FINISH TRAVELED PER MILE
5.
t S W
rn
r P,6
S' O a wV 1 ,1 1 5
5 6w rM
�5hflnK�,J ROW
5
�b l
MCX
Eeb YYl 1N
5W C
2 rno
0
z5
2-S.1 Nru5aQ S
eb
-zto 15rntgKI ktw
1- 09 Ztol M e�r'1 5
AUTO LICENSE NO. TOTALS ��J r O
I L
SPEEDOMETER READHiG columns are to be used only when distance between- points cannot 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
-and 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.
Amy Baldauf Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/4/08 reimb. Awards prizes 134.95
43/308 reimb. Travel for conference 112.27
4/4/08 reimb. Mileage reimbursement 70.95
4/4/08 reimb. Mileage reimbursement 65.40
Total 383.57
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.
Amy Baldauf Xlowed 20
In Sum of
383.57
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4239038 134.95 1 hereby certify that the attached invoice(s), or
1046 reimb. 4343000 248.62 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
14 -Apr 2008
gnat�r e
383.57 Business S (Zee
Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund