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155495 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360472 Page 1 of 1 4 ONE CIVIC SQUARE LYNN RUSSELL CARMEL, INDIANA 46032 829 DESERT WIND COURT CHECK AMOUNT: $230.00 CARMEL IN 46032 CHECK NUMBER: 155495 CHECK DATE. 1/110/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4359000 230.00 SPECIAL PROJECTS Carmel Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense 1 lu 4 3S'1Do a Jam- C) 0 C 1 211 s b So. p cD Sf Ork AU6 06ae t b[ (D 6. b0 C (a, un 610 C'Lb'L5 v D All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: v 30. Employeen Name (print) Y\C\- JAN 0 200 Address Check payable to: City, St, Zip` G�2 Signature: Approved by: Date: 1� Date: i�� ?-lag Revised 3 -2 -07 by Business Services; Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Lynn Russell Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12119/07 reimb. Gift cards for holiday celebration 230.00 Total 230.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20� Clerk- Treasurer Voucher No. Warrant No. Lynn Russell Allowed 20 In Sum of$ 230.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. r4359000 T #/TITLE AMOUNT Board Members Dept 1125 reimb. 230.00 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 4 -Jan 2008 Si tur 230.00 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund