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CITY OF CARMEL, INDIANA VENDOR: 361266 Page 1 of 1
0 ONE CIVIC SQUARE DUSTIN MENDENHALL CHECK AMOUNT: $638.03
CARMEL, INDIANA 46032 3525 N ELIZABETH ST
per INDIANAPOLIS IN 46226 CHECK NUMBER: 161477
CHECK DATE: 7111/2008
DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 138.03 GENERAL PROGRAM SUPPL
1047 4340800 500.00 ADULT CONTRACTORS
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Dustin Mendenhall
3525 N. Elizabeth St
Indianapolis, IN 46226
317.345.0443
DATE: JUNE 25, 2008
TO: FOR:
THE MONON CENTER Internship
Carmel Clay Parks and Recreation Independent Contractor Service Agreement
1235 Central Park Drive East
Carmel, Indiana 46032
Phone 317.573.5238 Fax 317.573.5254
DESCRIPTION RATE AMOUNT
Internship (Summer 2008)
July Billing $500 $500
JUN 2 6 2008
BY: I
q7. S bO .300 g
Total $500.00
I understand that this contract may be verbally terminated for any reason at any time.
I also understand that I am deemed as an independent contractor and am not considered an employee of CCPR.
In any case of discrepancy or if I have any questions, I will notify the Recreation Manager, Kate Schneider.
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expen
6/20/2008 Hobby Lobby 47 375 364 4239039 Family Special Events Supplies $138.03 Family Campout supplies
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All receipts should be attached in the same order as listed above. 7-
No sales tax will be reimbursed. TOTAL: $138.03
Employee Name (print) Dustin Mendenhall
Address 3525 N. Elizabeth St.
Check
payable to: City, St, Zip Indianapolis, IN 46226
Signature: App e by:
Date: 6/26/2008 Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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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.
361266 Mendenhall, Dustin
3525 N Elizabeth St Date Due
Indianapolis, IN 46226
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/25/08 Jul '08 Internship Jul '08 500.00
6/26/08 reimb Hobby Lobby/Family Lobby/Family campout supplies 138.03
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Total 638.03
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.
Allowed 20
361266 Mendenhall, Dustin
3525 N Elizabeth St
Indianapolis, IN 46226 In Sum of
638.03
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 Jul '08 4340800 500.00 1 hereby certify that the attached invoice(s), or
1047 reimb 4239039 138.03 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
3 -Jul 2008
Signature
638.03 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund