176387 08/19/2009 o•:�,;, CITY OF CARMEL, INDIANA VENDOR: 360624 Page 1 of 1
ONE CIVIC SQUARE TESS PINTER
CARMEL, INDIANA 46032 13046 DOLPHINS LN CHECK AMOUNT: $272.11
FISHERS IN 46037
CHECK NUMBER: 176387
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION
1047 4341993 272.11 STAFF RETREATS
Ca rmel a
Parks &Recreati ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
5/27/2009 Champps 47.000 400.100.4341993 Catering Services $164.13 May Staff Retreat
5/28/2009 The Journey 47.000 400.100.4341993 Catering Services 107.98 May Staff Retreat
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $272.11
Employee Name (print) Tess Pinter AUG 0 3 ZOQg
Check
Address 13046 Dolphins Lane
payable to: City, St, Zip Fishers, IN 46037
Signature: Approved by:
Date: ��1 /D� Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \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.
360624 Pinter, Tess Terms
13046 Dolphins Lane
Fishers, IN 46037
i
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/31/09 Reimb. Catering services for May Staff retreat 272.11
Total 272.11
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.
360624 Pinter, Tess Allowed 20
13046 Dolphins Lane
Fishers, IN 46037
In Sum of
272.11
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 Reimb. 4341993 272.11 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
13 -Aug 2009
Signature
272.11 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund