203779 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
ONE CIVIC SQUARE SUSAN BEAURAIN
ro CARMEL, INDIANA 46032 3737 KNICKERBOCKER PLACE 2 D CHECK AMOUNT: $145.40
INDPLS IN 46240
CHECK NUMBER: 203779
CHECK DATE: 11/21/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 145.40 TRAVEL FEES EXPENSE
Ca rmel a
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print 5U` 1Q D 11p11
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Address 11 G� NOV 1 0 2011
Check P
payable to: City, St, Zip P�U'M �l S I a &I-UO (OTO
Signature-F' Approved by:
Date: hQd �l 40 Date: rh 1
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request
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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.
363878 Beaurain, Susan Terms
3737 Knickerbocker place Apt 2D
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/9/11 Reimb Travel expenses for NPRA congress 145.40
Total 145.40
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.
363878 Beaurain, Susan Allowed 20
3737 Knickerbocker place Apt 2D
Indianapolis, IN 46240
In Sum of
145.40
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1091 Reimb 4343000 145.40 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
17 -Nov 2011
Signature
145.40 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund