164750 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 360464 Page 1 of 1
ONE CIVIC SQUARE LINDSAY HOLAJTER
.ja CARMEL, INDIANA 46032 6628 BEAR CREEK DRIVE APT 1424 CHECK AMOUNT: $8.09
ca`ron.i°�. INDIANAPOLIS IN 46254 CHECK NUMBER:. 164750
CHECK DATE: 1011612008
CEPARTMENT ACCOUN PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
1125 4342100 8.09 POSTAGE
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3
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
25 o Y 0 h u I Ln -r PY0 Paws
O CT 3
Y:
L N l receipts should be attached in the same order as listed above.
o sales tax will be reimbursed. TOTAL: T s 8-o
Employeen Name (print) Al
Address /'e1
Check
payable to: City, St, Zip �n 1l lls IAA ��J
Signature: �i G'% Approved by
Date: 101 :4101 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,
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
9/25/08 Reimb. Postage for mailing proposals 8.09
Total 8.09
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
8.09
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1125 Reimb. 4342100 8.09 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
6 -Oct 2008
Signature
8.09 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund