178825 10/28/2009 «k CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
y'1 ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $26.25
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
INDIANAPOLIS IN 45208 CHECK NUMBER: 178825
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 REIMB 17.25 CLUB ACTIVITY SUPPLIE
1046 4239038 REIMB 9.00 AWARDS PRIZES
Canes 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
25- Jun -09 Dollar Tree Stores 1046 4239038 Prizes $9.00 Awards and Prizes
1 -Jul -09 Blockbuster 1046 4239037 Supplies 4.99 Club Activity Supply
10- Jul -09 Kroger 1046 4239037 Supplies 5.29 General Program Supplies
10- Jul -09 Blockbuster 1046 4239037 Supplies 0.99 Club Activity Supply
22- Jul -09 Blockbuster 1 046 4239037 Supplies 4.99 v/ Club Activity Supply
29- Jul -09 Blockbuster 1046 4239037 Supplies 0.99 V/ Club Activity Supply
Outdoor Explorers 46- 210 -003
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $26.25
Employee Name (print) Nikeesha Pittman
ddress 2713 Highland Place OCT a 1 s 2009
Check
payable to: City, St, Zip Indianapolis, IN 46208
Signatu Approved by: C
Date: 10/13/2009 Date: po 1
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelFormslStaff FormslEmployee 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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/13/09 Reimb. Awards Prizes WB 9.00
10113!09 Reimb. Club suppliees WB 17.25
Total 26.25
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
20�
Clerk- Treasurer
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
26.25
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#rrlTLE AMOUNT Board Members
Dept
1046 reimb. 4239038 9.00 1 hereby certify that the attached invoice(s), or
1046 reimb. 4239037 17.25 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
22 -Oct 2009
P&IL/222MIL/
Signature
26.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
4'