157484 03/19/2008 CITY CARMEL, INDIANA VENDOR: 360878 Page 1 of 1
y ONE CIVIC SQUARE JESSICA L GROGG
CARMEL, INDIANA 46032 14024 BROAD MEADOW CHECK AMOUNT: $74.97
CARMEL IN 46032
CHECK NUMBER: 157484
o CHECK DATE:. 3/19/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 74.97 GENERAL PROGRAM SUPPL
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Carmel C ay
Parks &Recreation pB I ED
Employee Expense Reimbursement Request MAR 0 4 2008
3111 _C
Date of Fund Account Account Ei
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
0 Kka Of� %otagm GIKt S is l�k.�1 ��V1�U1 Q �ile5
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: �1
Employee Name (print)
Address
Check
payable to: City, St, Zip
Signature: Approved by:
Date: Date:
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
n invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
hom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Jessica Grogg
1225 W. Melrose, Apt. 2 Date Due
Chicago, IL 60657
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/23/08 reimb. birthday party supplies 74
Total 74.97
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
20_
Clerk- Treasurer
Voucher Warrant No.
Allowed 20
Jessica Grogg
1225 W. Melrose, Apt. 2
Chicago, IL 60657 In Sum of
74.97
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 reimb. 4239039 74.97 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
13 -Mar 2008
s natur
74.97 Busin ss Sees Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund