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158307 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 357435 Page 1 of 1 ONE CIVIC SQUARE ANDREW 'BURNETT 1' CHECK AMOUNT: $147.91 CARNIEL, INDIANA 46032 9215 N. PARK AVENUE INDIANAPOLIS IN 46240 CHECK NUMBER: 158307 CHECK DATE: 4115/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4343000 147.91 TRAVEL FEES EXPENSE I �i ff' l APR C armel Parks &Recreation 20 Employee Expense Reimbursement Request' Date of Receipt Vendor listed on receipt Fund Depart ment Account Line Acc Descripti Amount Purpose of Expense L �a P�oScrl6P�a�� ``©V Cv5 CO /Of x �3U000 7ravtl ql j ol i f ZS� q 3L 3 e o 40 11 7"Ol NC-e All receipts should be attached in the same order as listed above. TOTAL N Yl Name (print) A d ew U Check Address q P OLr k 1 qyy payable to: I n �5 .HIV 1 16 Z q U City, St, Zip Signature 6 Date: Approved by: Date: Revised 3 -2 -07 by Business Services 0 g *a�'t °uao�'' Andrew Burnett A/R Number 9215 Park Ave Indianapolis, IN 46240 Group Code Folio /Invoice No. Reference Room No. 355 Page No. 1 of 1 Arrival 04 -01 -08 Cashier No. 118 Departure 04 -02 -08 User ID JCHRISTENSON www .holiday inn.com /countrysideil Date Description Charges Credits 9 04 -01 -08 Lon Distance 21:28 #355 411 L [00:01:00] 0.30 04 -01 -08 "Guest Room 109.00 04 -01 -08 City Tax 5% 5.45 L 04-01-08 Occupancy Tax 6% 6.54 Total 121.29 0.00 Balance 121.29 Guest Signature: I have received the goods and or services in the amount shown heron. I agree that my liability for this bill is not waived and agree to be held personally liable in the event that the indicated person, company, or association fails to pay for any part or the full amount of these charges. If a credit card charge, I further agree to perform the obligations set forth in the cardholder's agreement with the issuer. Holiday Inn Countryside 6201 Joliet Rd Countryside, IL 60525 Telephone: (708) 3544200 Fax: (708) 3544241 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. Andrew Burnett Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/3/08 reimb. Travel fees Workshop 26.62 4/3/08 reimb. Travel fees Workshop 121.29 Total 147.91 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 i VouG6er No. Warrant No. Andrew Burnett Allowed 20 In Sum of 147.91 ON ACCOUNT OF APPROPRIATION FOR 101 1125 Gen Fund PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members Dept 1125 reimb. 4343000 147.91 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 14 -Apr 2008 Y 7�k Ig ure 147.91 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund