174830 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 363065 Page 1 of 1
ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $2.99
a CARMEL, INDIANA 46032 CIO PARKS- ESE
CHECK NUMBER: 174830
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
1046 4239099 REIMB 2.99 OTHER MISCELLANOUS
Carmel eClay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
to Y
r GJ 1 r.�'wl }`t1} cv) O l}Y bn�i1�ln
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1
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name (print) o t`, JUL 0 7 2009
Address
Check
payable to: City, St, Zip I 1 Q 6 L 06
Signature: Approved by:
Date. c� Date:
l�
Business Services Division, Revised 7 -7 -08
FILE: Shared \AdministrativelFormslSlaff 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.
Dowell, James Terms
14328 Banister Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/22109 Reimb. Repair broken glasses 2.99
Total 2.99
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.
Dowell, James Allowed 20
14328 Banister Dr
Noblesville, IN 46060
In Sum of
2.99
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. A.CCT #f'rITLE AMOUNT Board Members
Dept
1046 Reimb. 4239099 2.99 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
16 -Jul 2009
Signature
2.99 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund