HomeMy WebLinkAbout199363 07/20/2011 a- CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
ONE CIVIC SQUARE KURTIS BAUMGARTNER
CARMEL, INDIANA 46032 15468 FOLLOW DRIVE CHECK AMOUNT: $62.59
NOBLESVILLE IN 46060 CHECK NUMBER: 199363
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4230200 REIMB 62.59 OFFICE SUPPLIES
C arm el yr
marks &R ecreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
5/27/2011 Staples ?D0 G12 $66.917 Waterpark office items
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: 5.6,9.7,-
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Employee Name (print) Kurtis Baumgartner
Address 15468 Follow Drive
Check
payable to: City, St, Zip Noblesville, IN 46060
Signature: Approved by:
Date: (D 12-81 Date'
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative%Forms%Staff Forms\Employee Exp Reimb Request JUN 2 9 2011
BY.......................
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.
365288 Baumgartner, Kurtis Terms
15468 Follow Drive
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/27/11 Reimb Office supplies 62.59
Total 62.59
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.
365288 Baumgartner, Kurtis Allowed 20
15468 Follow Drive
Noblesville, IN 46060
In Sum of
62.59
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1091 Reimb 4230200 62.59 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
12 -Jul 2011
n'2_)
Signature
62.59 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund