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Home My WebLink About161854 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1 ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $787.30 CARMEL, INDIANA 46032 1847 WELCHWOOD CR, APT 289 INDIANAPOLIS IN 46260 CHECK NUMBER: 161854 CHECK DATE: 7/23/2008 DEPARTMENT J ACCOUNT P NUMB INVOICE NUMBE A MOUNT DES 1046 4239039 183.83 GENERAL PROGRAM SUPPL 1046 4343000 603.47 TRAVEL FEES EXPENSE Carrel o Clay Parks &Recreat Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense S qj 1(Z (S CAC, s �o 9 I M ��1r�b l�bb I s L�1� Cvs a S C A All receipts should be attached in the same order as listed above. 2 q No sales tax will be reimbursed. TOTAL: J O Employeen Name (print) l C%.�mGYlS Address W e �C� W OO V C Z JUL Check 2008 payable to: City, St, Zip cT ,5 oo Q Signature: Approved by: G J Date: C4 Date: Business Services Division, Revised 3 -2 -07 FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request PRESCRIBED BY STATE BOARD OF ACCOUNTS 7 1 C a -T� 14 101 (1986) MILEAGE CLAIM 1 JU L 0 8 2008 To (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR 6 1 (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) FROM TO SPEEDOMETER AUTO MILEAGE_ D- 6 E 0 READING NATURE OF BUSINESS MILES 5 p G POINT POINT START FINISH TRAVELED PER MILE 2 \t'J C- 7+` c_ k c'� 1g 4 as \NC- 1 fW -P-, w 5 i W L- lilt ov i�vti W c- i c,-,„ ov% `r.1c 1 °1 1 AUTO LICENSE NO. TOTALS 0�2 'So V SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. mil/ 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 du after allowing all just credits end that no part of the same has been paid. Date Claim No. Warrant No. I have examined the within claim and hereby IN FAVOR OF certify as follows: That it is in proper form. That it is duly authenticated as required by law That it is based upon statutory authority f That it is apparently Sl correct incorrect Disbursing Officer On Account of Appropriation No. for O tr a P (D O n n E5 rn d Allowed 19 k n PF, b in the sum of (D m a m w y fA 0 D a CL A O C) (Board or Commission) A- rt a FILED (D p, a rt n rA a (D w (Official Title) O O (D C (D c: tr A.E. BOYCE CO., INC. MUNCIE, IN 01136 n CL PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986) MILEAGE CLAIM 1 c Ri iT T TO �erC1c. •`M i(1n2�(1 JUL 0 8 2008 (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR BY:- (OF BOARD, DEPARTMENT OR INSTITUTION) FROM TO SPEEDOMETER AUTO MILEAGE DATE READING NATURE OF BUSINESS MILES 5 p 0 POINT POINT START' FINISH TRAVELED PER MILE 1 'NtJ C. o Is 6 2 C, 3 O Via— �t C^n iZ c-�,.w\. cbbt \-0b W L C— Haan S p S 9 co 1 <t R_ a IZ- i AUTO LICENSE NO. TOTALS C r� i y V 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 allowing all just credits end that no part of the same has been paid. Date {-Q IS •g �'7-03 Claim No. Warrant No. I have examined the within claim and hereby IN FAVOR OF certify as follows: That it is in proper form. That it is duly authenticated as required by law That it is based upon statutory authority. That it is apparently correct incorrect Disbursing Officer On Account of Appropriation No. for o W a P 0 0 y M w p A Allowed 19 a in the sum of 'L? k `D �-f m 0) tr CD E O ac o oe 0 t (Board or Commission) Ar o FILED P N+ M (D (D to m (Official Title) p o C fD !D b N A.E. EOYCE CO., INC. MUNCIE, IN 01136 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 Jennifer Hammons Terms 1847 Welchwood Cir 289 Date Due Indianapolis, IN 46260 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/27/08 Reimb. Program supplies 183.83 6/27/08 Reimb. Mileage 3/29/08 5/9/08 306.03 6/27/08 Reimb. Mileage 5/12/08 6/13/08 297.44 Total 787.30 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 1847 Welchwood Cir 289 Indianapolis, IN 46260 In Sum of 787.30 z ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund or Board Members Dept INVOICE NO. ACCT #/TITLE AMOUNT 1046 Reimb. 4239039 183.83 1 hereby certify that the attached invoice(s), or 1046 Reimb. 4343000 306.03 bill(s) is (are) true and correct and that the 1046 Reimb. 4343000 297.44 materials or services itemized thereon for which charge is made were ordered and received except 17 -Jul 2008 q3 Signature 787.30 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I lilllllllll� I�III!!i!i� ►1ll�illil A 1u022 NERFOOP I 95+ SUBTOTAL 3 99 T IN TAX 7.0000% on 3.99 0.28 TOTAL 4.27 w7503 DEBIT MAL PAYMENI 4.27 RECEIPT IDh 2- 8135 1848 0082 9500 -5 VCD# 759 -280 -654 TMO— Ax08r Win a A $5000 GiftCard Tell us about your last lIiopping e�%r,eriPrce at Target for a chance to win a $5000 Target GiftCard! Locate the Gift Registry Kiosk and select GUEST SURVEY. I le Or at home, log onto: wvAt Target com /survey User ID: 7186 4815 2991 Password: 704 995 Cuentanos acerca de to ultima e;periercia de compra en Target y tendr�rs la oportunidari de ganar Una tarjeta de regalo Target GiftCard por valor ire $5000. En el kiosco del registro de regalos, selecciona "Guest Survey" o visita www.target.com desde to Casa e ingr•esa la contraser)a v N de usuario de arriba. Normas disponibles en "Servicio al hu2sped" ONE WINNER PER MONTH! Guests must be 18 or older to enter. Sweepstakes runs from 04/01/08 through 06/30/08 Complete rules at„Guest Service Desk and Target c0m /s1JrvPy. (Target ream and, family riot eligibb lHio Lo 2',06 E. l't6th Street Carmel .71N 46032 (317) 818-9217 HOB-L #182 www.hobbylobby.com 5:26PN Apr 26./08 01-0001 UU5 ASHLEN -#05050 "CRAFTS c? FOOD r$0.67 CARD -D8IT-TRANSACTION-TAPPROV[D APR# C A REF# 81172110933 PAYNENT FROM DEFAULT Subtotal $10.66 TX 7.000 $0.75 lF OlFAN_ $11.41 --fT $11.41 TKANK PLEASE CONE AGAIN TUR POLICY ON BACK OF RECEIPT WE VALUE YOUR OPINION! WE WANT TO KNOW ABOUT YOUR SHOPPING EXPERIENCE TODAY AT WAL -MART. Please complete a survey about today's store visit at: http: /www.surve4.walmart.com You will need to enter the following online: STORE 1518 ID 5643202 PASSWORD: 1643 IN RETURN FOR YOUR TIME YOU COULD RECEIVE ONE OF FIVE $1000 WALMART SHOPPING CARDS Must be 18 or older and a lesal resident of the 50 US or DC to enter. No purchase necessary io enter or win. To enter without Purchase and for complete official rules visit www.entru.surveu.walmarf.com. Sweepstakes period ends on the date shown in the official rules. Survey must be taken within TWO weeks of today. Esta encuesta tambi6n se encuentra en espanol en la P gina del Internet THANK YOU rJ WE SELL FOR LESS MANAGER STEVE DUBBS 317 875 0273 ST# 1518 OP# 00009048 TE# 48 TR# 01633 POP ICE 007239276100 F 3.96 0 POP ICE 007239276100 F 3.96 0 POP ICE 007239276100 F 3.96 0 POP ICE 007239276100 F 3,96 0 POP ICE 007239276100 F 3.96 0 SUBTOTAL 19.80 TOTAL 19.80 TEND 19.80 ACCOUNT # APPROVAL #06519A TRANS ID 0088113825512612 VALIDATION -PQBM PAYMENT SERVICE -,E CHANGE DUE 0.00 ITEMS SOLD S TC# 2260 8263 6609 9869 9671 11 New products, Latest rollbacks. Sign up at Walmart.com /email 04/22/08 18:56:03 *CUSTOMER COPY DoRAR TnEF 'STORE'S, Store# 1375 (317) 876 -0335 3489 West 86th Stroat Ind ".ananolis IN 46268 DESCRIPTION OTY P ICE TOTAL PLANTER 1 1.00 1.00T PLANTER-- 1 1..00 1.00T PLANTER 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T BALLOON WEIGHT 1 1.00 1.00T FORKS 1 1.00 1.00T FORKS l 1.00 1.00T TABLECOVER 1. 1.00 1.00T TABLECOVER 1.00 1.00T BIG VALUE SPONGES 1 1.00 1.00T FORKS 1 1.00 t. OOT TABLECOVER l 1.00 1.00T .ZIPPER SNACK BAGS 1. 1.00 1.001 EXTRUDED DISC 1 1.00 1.00T EXTRUDED DISC 1 1.00 1.00T EXTRUDED DISC 1 1.00 1.001 PINE GLO DISINFECT 1 1.00 1.00T PINE GLO DISINFECT 1 1.00 1.00 Sub Tctal $22.00 SALES TAX $1.54 Total $23.54 Debit Total $23.54 Thank You for Shopl)i )g Dollar Tree Storc> Where Everything's $i.00 008211 1375 05 00051 31 4/02/08 10:59 Sales Associate:Robert FMO FW WE SEL, FOR LE:, MANAGER STEVE DUBLS 317 875 0273 ST# 1518 OP #.00009050 TE# 50 TR# 05354 COTTON 007874200100 0.97 X COTTON 007874200100 0.9 "r X COTTON 007874200100 0.97 X SUBTOTAL 2.91 TAX 1 7.000 0.20 TOTAL 3.11 TEND X 3.11 CHANGE DUE 0.00 EFT DEBIT PAY FROM PRIMARY ACCOUNT 3.11 TOTAL PURCHASE REF 809200132178 NETWORK ID. 0082 APPR CODE 013872 04/01/08 13:21:29 ITEMS SOLD 3 TC# 5123 2943 2996 6000 2039 New Products. Latest rollbacks. Sisn up at Walmart.com /email 04/01/08 13:21:31 T Was '206 t, CarpieR 3 17 �-To -921 HOB -Lq #a2 titm. hobby'lobby. co 10:45AM T Apr 13'08 01 -0001 UO:. SUEL!_M #05470 10 1.4-7 WL AR ART T$ 14.70 2 X1.99 WEA ART TT3.96 CRAFTS T0.99 2 X1.99 WEAR ART f #3.98 4 C", $1.99- PlEl' It TT7.96 IEAk r;t?f T$3.96 1'2 12.9:9 EA17 ART T135.88 2 2.9.% WF n'" ART Ts5.98 2 E WEAR ART T$1.98 �s ARD d4924A -*,PU ,JED APR# Z A0024A REF# -1 09 A J043 SUbtotor 08.41 TX 7.OPn X6.19 IT $94.6U VISA 94.60 THANK YOU PLEASE COME RETURN POLICY ON BACK Ot ,`IPT c WE VALUE YOUR OPINION!. WE WANT TO KNOW ABOUT YOUR SHOPPING EXPERIENCE TODAY AT WAL -MART. Please complete a survey about today's store visit at: http: /www.survey.walmart,com You will need to enter the following online: ID 4: lsc44njl r9Oe IN RETURN FOR YOUR TINE YOU COULD RECEIVE ONE OF FIVE $1000 WALMART SHOPPING CARDS Must be 18 or older and a Legal resident of the 50 (IS or DC to enter. No purchase necessary to enter or win. To enter without purchase and for complete official rules visit 7 www.entry.surveg.walmart.com. I Sweepstakes Period ends on the date shown in the official rules. Sur.v ey must be taken within TWO weeks of today. >T Esta encuesta tambien se encuent en espanol'en la P gina del Internet THANK YOU WE SELL, FOR LESS MANAGER STEVE DUBBS 317 875 ST4.1518 OP# 00009047 TEa 47 TRU 08350 r THEMEBOOK 00262297707,6 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 OJ 5 X THEMEBOOK 002622977076 0.15-X THEMEBOOK 00262 2977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X' THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X'' THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X! THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X THEMEBOOK 002622977076 0.15 X f. THEMEBOOK 002622977076 0.15 X 1:1r,,EBOOK X02622977076 0.15 X 1HEMEBOOK '.)02622977076 0.15 X THEMEBOOK 002622977076 0.15 X. THEMEBOOK 002622977076 0.15 X SUBTOTAL 3.75 TAX 1 7.000 °c 0.26 'TOTAL 4.01, CA'- TEND 5.00 CHANGE DUE 0.99 ITEMS SOLD 2S r Y TC# 0336 6675 080' 5532 586 comic stir,uIus ci, cashed4. Free. all of your r y. We can, nel.p,. 06/06/08 y:0•�:02 tr z N ARGET tPECT MORE PAY LESS: W)RA PLA.74 317- 810 -0044 308 11: 28 AM JPE`) ON 08/2`;/08 0820700i r i A SUB TO I At. 2 J.') T IN TA 7 .00OO4.' on 29.911 2.10 TOTAL_ 32.09 R7503 DEBIT TOTAL PAYMENT '32.09 RECEIP ID# 2 -1x48 -0073 1490 -9 �VCD# 7F'0- 280 -L-13 TM xAKXE)901 1 dc)wrr c.--ver iEi i 1 c -CUT HERE: Min s Your ticket to gift pertectia From: Hill 1III 1 ill4l I III III IN 11111 i With this receipt, you car r r'n your i ft for a G f t.Carcl. Some items can't be returned if opened. •RECEIPT EXPIRES ON 08/25/08 1 RECEIPT ID# 5 -8148- 1848 0073: 1490 -9 VCD# 750 -280 -243 TM #xx *x6901 CVS/pharmacyy for all the ways you care` 13090 PETTIGRU DRIVE, CARMEL, IN PHARMACY: 733 -8608 SPORE: REGu01 TRAND9693 CS11R0745921 STR#1367 EzfraCare Card MmO08970 1 WATERBOMB 150 0138 2.99T SUBTOTAL 2.99 IN 7.0% TAX .21 TOTAL 3.20 CASH 3.20 CHANGE .00 111111 lI I i 1111111111111 5136 7812 9969 3010 RETURNS WITH RECEIPT THRU 07/07/2008 MAY 8, 2008 12:50 PM