HomeMy WebLinkAbout165265 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 360464 Page 1 of 1
ONE CIVIC SQUARE LINDSAY HOLAJTER CHECK AMOUNT: $131.96
ip`.ao CARMEL, INDIANA 46032 6628 BEAR CREEK DRIVE APT 1424
INDIANAPOLIS IN 46254 CHECK NUMBER: 165265
CHECK DATE: 10129/2008
DEPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4341991 87.34 MARKETING PROMOTION
x`125 4343000 44.62 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS i� GENERAL FORM NO. 101 (1986)
MILEAGE ,CLAIM
I TO
(G V NMENTAL UNIT)
�I ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO i SPEEDOMETER AUTO MILEAGE
A6 n D� y T� NATURE OF BUSINESS MILES Q j READING �'��j� �j
f� U POI1.'T POINT START FINISH TRAVELED 4
PER MILE
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IRV-
OCT 9 0 2008
AUTO LICENSE NO. TOTALS 2, U 2
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
p I J l 2_ ;Jl `v 3`c 3 o o-,
Car a Clay
Darks &Recre
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
I ia��- 3 I g ti I Tver7f
i
All receipts should be attached in the same order as listed above. p 2
No sales tax will be reimbursed. TOTAL:
D
Employeen Name (print (_f �G OC T P, �QflB
Check Address (1 rf►' CirepL fir! V� BY:
payable to: City, St, Zip
Signature: Approved by:
Date: Isol Ob Date: J.;)L
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
INDIANAPOLIS NEWSPAPERS, INC. FAX PROOF
Ad Number 5341011
Customer: CARMEL CLAY PARKS RECREATION Contact: LINDSAY Phone: 3175734020
Price: 87.34
Section: CL Class: 251; GARAGE SALES NORTH
Size: 1 X 12 Start Date: 10/11/2008 End Date: 10/11/20080r-
dered: 2 Times
Class: 251; GARAGE SALES NORTH Printed By: C126 10/09/2008
Signature of Approval: Date:
1 GlRMECi'�:
,The Monon 'center"
r communityy Garage,
Safe. Sat. OcY(11, from
10 @m
,tr, 1aek D st _1, ,1735,Cen-
7 of Ran
geline; between
111th 116th'. FREE 70:
PllRUc, cancelled if
raining.`,
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.
360464 Holajter, Linday Terms
6628 Bear Creek Dr., Apt 1424 Date Due
Indianapolis, IN 46254
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/20/08 Reimb. Mileage 8/26/08 10/20108 44.62
10/20/08 Reimb. Garage Sale ad 87.34
Total 131.96
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.
360464 Holajter, Linday Allowed 20
In Sum of
i
131.96
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO #or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb. 4343000 44.62 1 hereby certify that the attached invoice(s), or
1047 Reimb. 4341991 87.34 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
20 -Oct 2008
Signature
131.96 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund