162652 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: .361544* Page 1 of 1
ONE CIVIC SQUARE KEISHA BORUFF
CARMEL, INDIANA 46032 5409 HOLLY SPRINGS DR W CHECK AMOUNT: $9.56
r y��on E� INDPLS IN 46254 CHECK NUMBER: 162652
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239039 9.56 GENERAL PROGRAM SUPPL
I
carmen U Oay
Par ks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
1 1
E No re ceipts should be attached in the same order as listed above. sales tax will be reimbursed. TOTAL:
c C =BY: ZD
Employeen Name (print) K-�� (lh� ����T
Address J�� y S�r� ��S V V
Check
p I�—
payable to: City, St, Zip I U I S l Q 2
'�xOYuf�
Signature: "h Approved by:
Date: 1 U O o Date:
Business Services Division, Revised 3 -2 -07
FILE: Shared \Administrative \Forms\Staff Forms \Employee Exp Reimb Request
J 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.
361544 Boruff, Keisha Terms
5409 Holly Springs Dr. W
Indianapolis, IN 46254
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
718108 Reimb Supplies 9.56
Total 9.56
k 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.
361544 Boruff, Keisha Allowed 20
5409 Holly Springs Dr. W
Indianapolis, IN 46254
In Sum of
9.66
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
()K. TO M A I L
PO #or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1046 Reimb 4239039 9.56 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
31-Jul 2008
Signature
9.56 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund