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164928 10/16/2008
CITY OF CARMEL, INDIANA VENDOR: 358684 Page 1 of 1 h 0 ONE CIVIC SQUARE SHANNON SHERMAN CARMEL, INDIANA 46032 16616 WIMBLEY WAY CHECK AMOUNT: $10.00 NOBLESVILLE IN 46060 CHECK NUMBER: 164928 CHECK DATE: 10116/2008 D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION 1046 4239037 10.00 CLUB ACTIVITY SUPPLIE CARMEL CLAY PARKS RECREATION REIMBURSEMENT REQUEST Carmel® Clay Parks &Recreation RECEIPT DATE OF VENDOR LISTED ON ACCOUNT LINE PURPOSE OF CLAIM NUMBER RECEIPT RECEIPT FUND DEPARTMENT NUMBER ACCOUNT DESCRIPTION AMOUNT EXPENSE SHEET c. GI C D c m 3 ,q Total Reimbursement Request: $OM Signa e� Date: -�3© Supervisor's Signature: Date: REC�� SEP 1 p �nn� 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 L whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 18564 F 358684 Sherman, Shannon Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/30/08 Reimb. Marsh pumpkins for site celebration 10.00 Total 10.00 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 ;t Voucher No. Warrant No. 358684 Sherman, Shannon Allowed 20 In Sum of 10.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 Reimb. 4239037 10.00 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 1 -Oct 2008 Signature 10.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund