161266 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1
i ONE CIVIC SQUARE AMY BALDAUF CHECK AMOUNT: $105.75
CARMEL, INDIANA 46032 9441 BENCHMARK DR APT B
9 INDIANAPOLIS IN 46240
CHECK NUMBER: 961266
CHECK DATE: 7111120 08
DE PARTMENT W A CCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
1046 4239037 J 105.75 CLUB ACTIVITY SUPPLIE
T;
Fn
c arme0 U 0ay
Parks& Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
G o O` 9A5 C,Lkg SONUf i 52- Air►VrTk
��ubrn P t Zp
f ll receipts should be attached in the same order as listed above.
o sales tax will be reimbursed. TOTAL:
Employeen Name (print) CIU�� CRIVE
Address GI'1mo, Y JUN 2 5 2008
Check
payable to: City, St, Zip .I1Q� 15 4 �N H W21 HO BY:
Signature: Approved by:
Date: �Q O Date:
B+asiness Services Division, Revised 3 -2 -07
FILE: Shared\Administrative \Forms \Staff Forms\Employee 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.
Baldauf, Amy Terms
9441 Benchmark Dr., Apt. B Date Due
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/24/08 reimb. Club supplies 105.75
Total 105.75
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Baldauf, Amy Allowed 20
9441 Benchmark Dr., Apt. B
Indianapolis, IN 46240
In Sum of
105.75
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4239037 105.75 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
1-Jul 2008
Signature
105.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund