155431 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 36046E Page 1 of 1
ONE CIVIC SQUARE CONNIE MURPHY
CARMEL, INDIANA 46032 9 HENSEL CT CHECK AMOUNT: $355.61
CARMEL IN 46033 CHECK NUMBER: 155431
CHECK DATE: 111012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESC RIPTIO N
1047 4239039 1125 286.91 GENERAL PROGRAM SUPPL
1125 4342100 1125 34.65 POSTAGE
1125 4343000 1125 34.05 TRAVEL FEES EXPENSE
I
Carmel 0 Clay
Parks &Recreation DEC 2 1 2007
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
R
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employeen Name (print) �nnt I I IU
Address 4tA6ei Ct
Check
payable to: City, St, Zip I /J x 11 co
Signature: Approved by:
Date: I z.l r
ZI I C Y- 7 Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
Carm e Clay
Parks &Recreation JAN 0 2 2008
Employee Expense Reimbursement Request ll aA
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
/�NLt ��4j2loo ?"JIML-1
t�l UPS 1I;�S `012-100 po 5
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: I s
Employeen Name (print) L orli'L
Address vE
Check
payable to: City, St, Zip N
Signature: t Approved by:
Date: 2— 8 Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
PRESCRIBED By STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO- Q
(GOVERNMENTAL, UNIT D E `2 v
ON ACCOUNT OF APPROPRIATION NO. FOR I 2 I
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) B •.�(_f V [Q
SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS AUTO C AE x
POINT POINT STAE FINISH TRAVELEDf PER MILE
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AUTO_ LICENSE NO. TOTALS 1 �0 �Zo OG�
SPEEDOMETER READING columns are to be used only when distance between points cannot be dete (mined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the a /clamed all due
Date
`f after allowing all just credits
and that no part_ of the same has been paid. f
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fix'
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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R.E. BOYCE CO., INC. MUNCIE. Bi 01136. Q.
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.
Connie Murphy Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/21/07 reimb. Mileage reimbursement 34.05
1/2/08 reimb. Postage 34.65
12/21/07 reimb. Breakfastw /Santa supplies 286.91
Total 355.61
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.
Connie Murphy Allowed 20
In Sum of
355.61
ON ACCOUNT OF APPROPRIATION FOR
101_ General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 reimb. 4343000 34.05 1 hereby certify that the attached invoice(s), or
1125 reimb. 4342100 34.65 bill(s) is (are) true and correct and that the
1047 reimb. 4239039 286.91 materials or services itemized thereon for
which charge is made were ordered and
received except
4 -Jan 2008
S' t e re
355.61 Business i es Manager
Cost distribution ledger classification if
claim paid motor vehicle highway fund