180788 12/30/2009 "A. CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN DECKER
CARMEL, INDIANA 46432 CHECK AMOUNT: $98.05
CHECK NUMBER: 180788
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1046 4239037 4.44 CLUB ACTIVITY SUPPLIE
1046 4342100 27.44 POSTAGE
1046 4343004 66.17 TRAVEL PER DIEMS
g M
C armelo o Clay
Parks &Recreato ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Exp ee n ss e en.�
q3q,)-1da
P057 G
All receipts should be attached in the same order as listed above.
No sales t ax will be re im burs ed. T O T AL:
Employee Name (print) P G DEC 0 3 2009 U
I�
Address r W 1Otn/ I" (3 13Y:
Check payable to. City, St, Zip �V �V
Signature Approved by:
Date. Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelForms\Staff Forms\Employee Exp Reimb Request
Carrel Q Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
ts co� poc�
y
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) M w�aal� 4 pa) DEC �QQ
11 1
Address �l f LgLl I
CheckJay.
payable to: City, St, Zip 661 7
Signature: ftl Approved by: E kX e-
Date. I Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative`Forms \Staff Forms\Employee Exp Reimb Request
.l
PRESCRIBED BY STATE HOARD OF ACCOUNTS
GENERAL FORM 110. 101 11986)
MILEAGE CLAIM 9 -41 7 TO 9 L
(GOVERNMENTAL UNnT FOR
ON ACCOUNT OF APPROPRIAT N NO.
(OFICE. BOARD, DEPARTWIDIT OR INST[Nr10N)
SPEEDOMETER AUTO
DATE FROM TO I READING NATURE OF BUSINESS MILES d 5
2 POINT POINT START FINISH TRAVELED
PER MILE
t tivL 12i U o
y'y" S c `S o
dD CIO Y\;\ 2
3 0 ZLA
or S
CcLe
0 1
f J r OiF t,5 71
Adpayl P_ L +-v &12
t yi t
t I Ght7a 12A 6 76
on bb l n
un v t
21A 1OZ4 Cie'
I
AUTO LICENSE NO. 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 "s ally due, after a ing just credits
and that no part of the same has been paid.
Date
0
1
DEC 0 2009
."'Irmo JaY
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.
363382 Decker, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/25/09 Reimb. Postage for return 27.44
1214/09 Reimb. Club supplies PT 4.44
12/1/09 Reimb. Mileage 11/3 11/24/09 66.97
Total 98.05
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_
Cleric- Treasurer
Voucher No. Warrant No.
363382 Decker, Meagan Allowed 20
In Sum of
98.05
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4342100 27.44 1 hereby certify that the attached invoice(s), or
1046 Reimb. 4239037 4.44 bill(s) is (are) true and correct and that the
1046 Reimb. 4343004 66.17 materials or services itemized thereon for
which charge is made were ordered and
received except
23 -Dec 2009
Signature
98.05 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund