175081 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
t ONE CIVIC SQUARE NIKEESHA PITTMAN
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK AMOUNT: $154.48
INDIANAPOLIS IN 46208 CHECK NUMBER: 175081
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT P N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 96.58 CLUB ACTIVITY SUPPLIE
X046 4343004 57.90 TRAVEL PER DIEMS
Carmel 0 Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of
Receipt Vendor listed on receipt Fund Department Account Line Account Description Amount Purpose of Expense
13- May -09 Walmart 1046 ESE Belt Bag /First Aid Bag /First Aid
23 v ,,q
4- Jun -09 McCormick's Creek State Parl Field Trip ✓40.00 Field Trip
5- Jun -09 Blockbuster 4 631 Activities b 5.34 Activities
9- Jun -09 Eagle Creek State Park Field Trip Parking X15.00 Field Trip Parking
9- Jun -09 Michael's Supplies Supplies
10- Jun -09 Blockbuster Activities LaI5' Acivities
-k6.
11- Jun -09 Garfield Park Field Trip 21.00 Field Trip
22- Jun -09 Blockbuster Activities 1 Activities
All receipts should be attached in the same order as listed above. q .JCg
TOTAL 9
Name (print) Nikeesha Pittman
g
Check Address 2713 Hi Place JUL J U L 0 2 2009
payable to.
City, St, Zip Indianapolis, IN 46208
Signature N 9 XI w F Date: 26- Jun -09
Approved by:
f Date: 0 2
Revised 3 -2 -07 by Busines rvices
PRrSCAIBLD BY STATE BOARD OF ACCOUNTS Ci DNFAAL FOAM NC. +ol !1966)
MILEAGE CLAIM
)oovrAxHBNrALtnun ON ACCOUNT OF APPROPRIATION NO. FOR LKEESk��jSTMA?�
F. tom Gum Eu�M �r�T
+OFFICE, BOARD, DEFAATMEN7 OA 1N ION)
SPEEDOMETER
FROM TO AUTO AGE
DATE FROM READING f. MILES is c
26 _ocl POINT POINT START F1N1SH NATURE OF BUSINESS TRAVELED PER MILE
�l G /AGO Mt- 3 O
Ins d I E5
1 CTS W DDD0i2- Ck T:Ag(x =T 6-+0 SCE 0 15
G IB v�DD�ti 1� EV'c .5ci' -S 6 rw 3. O ('S
b O bpvp Oi i 65
MDt 1Dt� G W LX?t (00 M L-5
I� �hbt -rCJ i lZ Gi�LM P GR��`
l CA��fT(ti� uRGi1A PUE I 67 9.11
r C XLA 11 A wee4 o�c t :ar -os• F�j ,-^r CA fz�S eF- e+„C =3v
111..t F- C3 I.
iZac
L N W�OGlE3 flG ?✓l ?u l
I o RCcf¢AC J a •SfAU svfz
Z N K-f ocri -v— V luS -W i0N erp— t•i21'1.L C '2- n �J
2 p -v ot= v 4 06 n W eTt r SU F PL't
9 D r Px'l+P,w. u u r. .Z
AUTO LICENSE NO. y TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is le ally +ca, after allowing all just credits
end that part of'the same has been paid.
Date
J U L 0 2 2009
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
6/29109 reimb. Supplies 96.58
5129109 reimb. Mileage 5101109 5129/09 57.90
Total 154.48
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
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
154.48
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reim b. 4239037 96.58 1 hereby certify that the attached invoice(s), or
1046 reimb. 4343004 57.90 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
154.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I