166136 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 027850 Page 1 of 1
I 0 ONE CIVIC SQUARE JAMES BRAINARD CHECK AMOUNT: $478.44
CARMEL, INDIANA 46032
CHECK NUMBER: 166136
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
if 5023990 478.44 OTHER EXPENSES
I
I
I
Page 1 of 1
Lingelbaugh, Shelly M
From: Lamb, Barbara A
Sent: Monday, November 17, 2008 12:21 PM
To: Lingelbaugh, Shelly M
Subject: Claim
Shelly, please prepare a claim for the Mayor against the medical fund. He pays the entire year's premium in
advance, so we have to refund his November and December premiums. The amount of the refund is 478.44.
Thank you.
Barbara A. Lamb
Director of Human Resources
City of Carmel
One Civic Square
Carmel, IN 46032
Phone: 317- 571 -2471
Fax: 317 -571 -2409
Email: blamb @carmel.in.gov
`A Please consider the environment before printing this e -mail
11/17/2008
Prescribed State Board of Accounts City Form No. 291(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
r
An invoice or 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
James Brainard Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/i 7/08 Refund of ovem er and December Premiums $4 78.44
Total
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.
-1 80 172 Tm
'James Brainard ALLOWED 20
IN SUM OF
$478.44
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
301 Medical Fund
Board Members
PO# or D PT. INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
44 materials or services itemized thereon for
which charge is made were ordered and
received except
20
f I natu 'e
1 Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund