HomeMy WebLinkAbout168333 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 361411 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL ALLEN CHECK AMOUNT: $155.91
CARMEL, INDIANA 46032 2411 CUMBERLAN STREET
o� zo P o BOX 468 CHECK NUMBER: 168333
DUBLIN IN 47335
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
X1047 4239039 REIMB 155.91 GENERAL PROGRAM SUPPL
Carmel o Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
CO
1/12/2009 Toy R US 47.J,9V %M.4239039 Program/ Class Su lies $155.00 Block Party/ Shake, Rattle Roll
ti.
Ail receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $155.00
Employee Name (print) Crystal Allen
Address P.O. Box 468
Check
payable to: City, St, Zip Dublin, 47335
Signature: ltd Approved by: P10 'T6
Date: 1 I Tag Date: w o c l
C F,IV EE)
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\Forms\Staff Forms\Employee Exp Reimb Request JAN 2 9 2009
BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
s 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.
361411 Allen, Crystal Date Due
P.O. Box 468
Dublin, IN 47335
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/12/09 Reimb. Program Class supplies 155.00
Total 155.00
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
4k
Voucher No. Warrant No.
Allowed 20
361411 Allen, Crystal
P.O. Box 468
Dublin, IN 47335 In Sum of
155.00
i
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1047 Reimb. 4239039 I 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
2 -Feb 2009
"i Signature
$Q Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund