161738 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361544 Page 1 of 1
0 ONE CIVIC SQUARE KEISHA BORUFF CHECK AMOUNT: $5.97
CARMEL, INDIANA 46032 5409 HOLLY SPRINGS DR W
INDPLS IN 46254 CHECK NUMBER: 161738
CHECK DATE: 7/23/2008
D ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1046 4239039 5.97 GENERAL PROGRAM SUPPL
Carmel ®Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
l0 U w of MCtiV�- o�(� y�� C e e �l o o d �S q fl 6(ase n W W 5
C�
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employeen Name (print)
Address 5101 -Roll S ��n S �r V�► 7BY: L 0 8 2uU8
4 Check
payable to: City, St, Zip '����1IVI��'IS �1�� D -___�I
Signature: (/l Approved by:
Date: L Q LJ 0 Date:
Business Services Division, Revised 3 -2 -07
FILE: Shared\Hdministrative \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.
Boruff, Keisha Terms
5409 Holly Springs Dr. W Date Due
Indianapolis, IN 46254
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/2/08 reimb. Dry Erase markers College Wood 5.97
Total 5.97
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
i
Voucher No. Warrant No.
Boruff, Keisha Allowed 20
5409 Holly Springs Dr. W
Indianapolis, IN 46254
In Sum of
5.97
ON ACCOUNT OF APPROPRIATION FOR
104 Program
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1046 reimb. 4239039 5.97 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
16 -Jul 2008
Signature
5.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund