179120 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 362613 Page 1 of 1
ONE CIVIC SQUARE LINDSAY ATKINSON CHECK AMOUNT: $7.58
CARMEL, INDIANA 46032
-b CHECK NUMBER: 179120
CHECK DATE: 11/11/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 REIMB 7.58 GENERAL PROGRAM SUPPL
Carmel ay
Par &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account Jf
Receipt Vendor listed on receipt Line Budget Description Amoun Purpose Purpose of Expense
10/19/2009 UPS Store "q�_ _U, �q o ��at Si 3`1 C
10/2112009 USPS -q 039 P ay ,k L4 Cb'
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: D
�a
Employee Name (print) Lttij It ►`1' �OV 209
Address y(� Genf
Check
payable to: City, St, Zip FIS�t.Y� (/�1 `7 l��
Signature: Approved by:
Date: %((1 0� a Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAd min istrative\Forms\Staff Forms\Employee Exp Reimb Request
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.
362613 Atkinson, Lindsay Terms
11407 Teal St., 1408
Fishter, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/21/09 Reimb. Youth general supplies 7
Total 7.58
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.
362613 Atkinson, Lindsay Allowed 20
11407 Teal St., 1408
Fishter, IN 46038
In Sum of
7.58
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#1TITLE AMOUNT Board Members
Dept#
1047 Reimb. 4239039 7.58 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
5 -Nov 2009
Signature
7.58 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund