164264 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA.46032 10868 GUNNISON CT CHECK AMOUNT: $56.80
FISHERS IN 46038 CHECK NUMBER: 164264
CHECK DATE: 9130/2008
DEPA AC PO NU MBER INVOICE N AMOUN DESCRIPTION
1046 4239037 56.80 CLUB ACTIVITY SUPPLIE,
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efi
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Ve listed on receipt Line Budget Description Amount Purpose of Expense
S,Z `J(1��CCJ C lo q Li?- 3903 -4 r1e^r� 5 CS 5U .!lO
All receipts should be attached in the same order as listed above.���
No sales tax will be reimbursed. TOTAL: FL SEP
Y 2 2008
By
Employeen Name (print) J� (1 c VY-\ cy
Address I OK� G uv\ r
Check
;payable to: City, St, Zip 5
Signature: Approved by:
i
ff
Date: c l 1 l Date: y
Business Services Division, Revised 3 -2 -07
FILE: Shared\Administrative\Forms \Staff Forms \Employee Exp Reimb Request
ACCOUNTS PAYABLE VOUCHER
4 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 Jennifer Hammons Terms
10868 Gunnisan Ct Date Due
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/29/08 Reimb. Supplies 56.80
Total 56.80
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
Voucher No. Warrant No.
358411 Jennifer Hammons Allowed 20
10868 Gunnisan Ct
Fishers, IN 46038
In Sum of
l
56.80
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4239037 56.80 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
15 -Sep 2008
LIZ
Signature
56.80 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund