166714 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360926 Page 1 of 1
ONE CIVIC SQUARE SHAVONNE HOLTON
0 CHECK AMOUNT: $111.72
CARMEL INDIANA 46032
s•,�e' 8001 CANARY LANE, APT A
INDIANAPOLIS IN 46260 CHECK NUMBER: 166714
CHECK DATE: 1211012008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
TO4f 4239037 111.72 CLUB ACTIVITY SUPPLIE
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ar e (L) C 8a
Parks &Rec reation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receip t Vendor listed on receipt Line Budget Description Amount Purpose of Expense
UA
I
All should be attached in the same order as listed above.
sales tax will be reimbursed. TOTAL:
Employeen Name (print) a V o n n �4 �4 r)
Address O1 C_
Check
payable to: City, St, Zip
Signature: Approved by:
Date: Date:
Business Services Division, Revised 3- 2- 07� -�"L
FILE: Shared4Administrative \Forms \Staff Forms\Employee Exp Reimb Request DE 0 1 2008
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.
360926 Holton, Shavonne Terms
8001 Canary Ln Apt A Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/24/08 Reimb. Target Club supplies 111.72
Total 111.72
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
I
Voucher No. Warrant No.
360926 Holton, Shavonne Allowed 20
8001 Canary Ln Apt A
Indianapolis, IN 46260
In Sum of
111.72
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb.. 4239037 111.72 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
1 -Dec 2008
Signature
111.72 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund