174736 07/22/2009 �'��Q4 F CITY OF CARMEL, INDIANA VENDOR: 362613 Page 1 of 1
ONE CIVIC SQUARE LINDSAY ATKINSON CHECK AMOUNT: $10.69
CARMEL, INDIANA 46032
CHECK NUMBER: 174736
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
w 1047 4239039 REIMB 10.69 GENERAL PROGRAM SUPPL
Carmel Clays
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
l slob U FS L] pp �y� Lja o q W0 a, ;u 0. 10. Wch h n c pvnr
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL.:
Employee Name (print) brads" 4u ry I
Address
79 1 (yens b n ph-lc i2d J U' Q 2 2009 1
Check I
payable to: City, St, Zip �Yf 4 �O(� 1 N `7 1
Signatur Approved by:
Date: Q� Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative% ormslStaff FormslEmployee Exp Reimb Request
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt 'Vendor listed on receipt, Line Budget Description Amount Purpose of Expense f N receipts should be attached in the same order as listed above. r q
sales tax will be reimbursed. TOTAL:
f
Employee Name (print) Ll�d �u I ��n 7.
q f t
Addres l 1 k Pm 12d, °b JUj :t
Check 009 J
payable to: City, St, Zip (y- .e _On tk)00Q�
Sig natur Approved by:
('XT 0
Date: �P Qq Date: 0(ao L0q
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrative \Forms\StaK 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
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6126/09 Reimb. Mailing archery equipment 10.69
Total 10.69
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
362613 Atkinson, Lindsay Allowed 20
In Sum of
10.69
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #frITLE AMOUNT Board Members
Dept
1047 Reimb. 4239039 10.69 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
16 -Jul 2009
Signature
10.69 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund