157953 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 1847 wELCHWOOD CR, APT 289 CHECK AMOUNT: $327.19
INDIANAPOLIS IN 4626D
CHECK NUMBER: 157953
CHECK DATE: 4/1/2008
DEPA ACCOUNT PO NU MBER INVOICE NUMBER AM DE
1046 4239037 30.75 CLUB ACTIVITY SUPPLIE
1046 4343000 296.44 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILE.kGE CLAIM
TO
r- r- n 2 7 2008
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
tL a
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) y
SPEEDOMETER
DATE
FROM TO READING AUTO MILEAGE
i NATURE OF BUSINESS MILES x
19 POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS 5 0 l
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
and that no part of the same has been paid.
Date c�
Claim No. Warrant No. I have examined the within claim and hereb}
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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Allowed 19— 0 a a
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in the sum of Er M.
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N A.E. BOYCE CO., INC. MUNCIE, IN 01136
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a[' el 0 Clad/ 7FF7FR` 9 2008
Parks &Recreation BY 3&
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
�O G•�YY�c%� CD t I S CQ.' r`c.�i
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 1 $3 O
Employeen Name (print)
Address
Check A
payable to: City, St, Zip C1I�C;.��, S, \'N I AU ZASO
Signature: Approve
Date: `1�1� �j Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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.
Jennifer Hammons Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/26/08 Reimb Request mileage reimbursement 296.44
2/29/08 Reimb Request ESE supplies 30.75
Total 327.19
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
Voucher No. Warrant No.
Jennifer Hammons Allowed 20
In Sum of
327.19
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb Req 4343000 296.44 1 hereby certify that the attached invoice(s), or
1046 Reimb Req 4239037 30.75 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
25 -Mar 2008
7S
Signatu e
327.19 Business Sery es Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund