HomeMy WebLinkAbout199050 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 360925 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HOLDER
I{ CARMEL, INDIANA 46032 5716 DURHAM CASTLE CT APT 137 CHECK AMOUNT: $9.48
INDPLS IN 46250 CHECK NUMBER: 199050
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 9.48 GENERAL PROGRAM SUPPL
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
Generic Tylenol and
6/2/2011 CVS Pharmacy 1082 -9 4239039 Chillville Supply Bud et 14 Benedryl for Chillville
GIy�<
All receipts should be attached in the same order as listed above. 19
No sales tax will be reimbursed. TOTAL: 4
Employee Name (print) Jennifer Holder
Address 1235 Central Park Dr. East
Check
payable to: City, St, Zip Carmel, IN 46032
Signature: Approved by:
Date: 6/14/2011 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request
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.
Terms
360925 Holder, Jennifer
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s)) PO
Date Number 9,48
6114!11 Reimb supplies
Mileage7/6-11/30/
Total 9.48
I 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
Voucher No. Warrant No.
360925 Holder, Jennifer Allowed 20
In Sum of
9.48
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#f AMOUNT Board Members
Dept
1082 -9 Reimb 4239039 9.48 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
28 -Jun 2011
Signature
9.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
a
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