161854 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
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1(Z (S CAC, s �o
9 I M ��1r�b l�bb I
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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
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y
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0
D a
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(Board or Commission) A- rt
a
FILED (D p, a
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a (D
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(Official Title) O
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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