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Home My WebLink About198547 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1 ONE CIVIC SQUARE JENNIFER HAMMONS CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK AMOUNT: $688.71 4 INDIANAPOLIS IN 46220 CHECK NUMBER: 198547 CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 REIMB 61.89 GENERAL PROGRAM SUPPL 1081 4340800 REIMB 340.00 ADULT CONTRACTORS 1081 4343000 REIMB 165.75 TRAVEL FEES EXPENSE 1082 4239039 REIMB 121.07 GENERAL PROGRAM SUPPL PRESCRIBED BY STATE BOARD Or ACCOUNTS GENFAAL FORM HO. Irl (19BE) MILEAGE CLAIM l 111 l tOOVEANMENTAL UNITI ON ACCOUNT OF APPROPRIATION NO. FOR fi (OFFICE, BOARD. DEPARTMENT OR INSTaUTIoN) $P EFDOMETER DATE FROM TO I READING AUTO MILEAGE P NAT[IRE OF BUSINESS NILES OINT POINT START FINISH PER MILE r lC7 1 o Y1 t C. C— l0 �G C) O Z CJ I C-1 L 0 G r, a n Ono c a0 inl 2- m 2.Z_ V�iC ol �l1 2Z ilao in Z Ci,f c c q 0 ov, V`i C_ AUTO LICENSE NO. TOTALS SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allow' g all j cr 'ts end that no part of the same has been paid. Date C o 04 I q 3 �'3 y z� 177 7- g MAY 2 0 1011 u BY: Carmel 0 Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense C9�(� i± S I o. a� 4 S3 I� U l J ATII receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: Employee Name (print) Address c) Check payable payable to: City, St, Zip Signature: Approved by: Date: l Date: Business Services Division, Revised 7 -7 -08 FILE: Shared \,4dministrative�Forms\Staff Forms`Employee Exp Reimb Request MAY 2 1011 t �a Carm Clay Parks &Recreati ®n Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense S a 7- I� c'�ol IM H(-) q 5 qogm Wen ck- cc 3 q C� oac@ F I Ireceipts should be attached in the same order as listed above. ff No sales tax will be reimbursed. TOTAL: �i f. Employee Name (print) I\`(`(\c.p L Address mot �J �Q'.-s BY: Check i payable to: City, St, Zip Signature: Approved by: Date: Date: Business Services Division, Revised 7 -7 -08 FILE: Shared lAdministrativelForms\staff FormslEmpioyee Exp Reimb Request �ar°mel 0 Clay Parks &Re creation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense c�t11Gr4 (C52. z 3�tCj �'c eLCS;dQ v� C'-c s All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: r 1 Employee Name 1 (Print) �2 �r ►1 p j IA Address d yl (I �j 011 Check payable to: City, St, Zip 1 x1 i Q� ,Q� �2 Z B Y:.......... Signature: Approved by: �f j Date: Date: 0'I r Business Services Division, Revised 7 -7 -08 FILE: Shared \AdministrativelForms\Staff Forms%Employee Exp Reimb Request Carmel r-; Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense 2-911) VG �5' All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: Employee (Name (print) 1 -Y2 C_MfV\c/Y15 Address Check payable to: City, St, Zip f o fN Q0Gk +S i a i Signature: Approved by: 7 Date: S� Date: T Business Services Division, Revised 7 -7 -08 FILE SbaredlAd mini strativel Form s \Staff FormslEmpioyee Exp Reimb Request t 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. 358411 Hammons, Jennifer Terms 634 Northview Ave Date Due Indianapolis, IN 46220 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5/17/11 Reimb. Mileage 1/4 3/22/11 165.75 5/3/11 Reimb. Supplies 61.89 6/2/11 Reimb. Caterer 340.00 6/1/11 Reimb. Activity supplies 8.79 5/31/11 Reimb. Supplies 112.28 Total 688.71 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. 358411 Hammons, Jennifer Allowed 20 634 Northview Ave Indianapolis, IN 46220 In Sum of 688.71 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -10 Reimb. 4343000 165.75 1 hereby certify that the attached invoice(s), or 1081 -10 Reimb. 4239039 61.89 bill(s) is (are) true and correct and that the 1081 -10 Reimb. 4340800 340.00 materials or services itemized thereon for 1082 -1 Reimb. 4239039 8.79 which charge is made were ordered and 1082 -1 Reimb. 4239039 112.28 received except 16 -Jun 2011 Signature 688.71 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund