157094 03/05/2008 c CITY OF CARMEN, INDIANA VENDOR: 360925 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HOLDER CHECK AMOUNT: $39.94
a CARMEL, INDIANA 46032 326 SHADY LANE
NEWBURGH IN 47630 CHECK NUMBER: 157094
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
'0..:046 4239037 7.38 CLUB ACTIVITY SUPPLIE
:1046 4239040 32.56 FOOD BEVERAGES
Carmel Clay �CFI ff
Parks &Recreation FEB 1 4 2008
Employee Expense Reimbursement Request BY:
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
J'S �f �sIM -d ESC
LO_ kV 5Ut
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) OJI' IPUL �04b_('--
Address 5 I t _NWA OS Cr
Check
payable to: City, St, Zip �D I -,,JObU S
Signature: Approved by:
Date: i�`-� I J Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
ACCOUNTS PAYA6LE 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 Holder Terms
Date Due
invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/13/08 reimb.. ESE supplies 39.94
Total 39.94
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
i
Voucher No. Warrant No.
Jennifer Holder Allowed 20
In Sum of
39.94
ON ACCOUNT OF APPROPRIATION FOR
104- Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4239037 7.38 i hereby certify that the attached invoice(s), or
1046 reimb. 4239040 32.56 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
29 -Feb 2008
Signature
39.94 t Director
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund