168350 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1
ONE CIVIC SQUARE AMY BALDAUF CHECK AMOUNT: $47.38
CARMEL, INDIANA 46032 126 LARK DR
APT CHECK NUMBER: 168350
CARMEL IN +16032
CHECK DATE: 2/412009
DEPARTMENT ACCOUNT P NUMBER INVOICE NUM AMOUNT DESCRIPTION
1046 4239037 REIMB 47.38 CLUB ACTIVTTY SUPPLIE
I
s
e.
Carmel Clay
Parks &Pecrealtion
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
ran4\,� 5 0 o� c� SLR
4�
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: —7.
Employee Name (print) ��G JAN 2 2 2009
i
Address 1 1 2 u u Y (Sah& t04) BY: Y
Check
payable to: City, st, Zip LW Wt' 1 I n� Y
Signature: Approved by:
Date: 0 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative\FcrmsVStaff Forms\Ernployee 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.
360484 Baldauf, Amy Terms
126 Lark Dr., Apt. D Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/19/09 reimb. Club supplies Menard's 1/19/08 47.38
Total 47.38
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.
360484 Baldauf, Amy Allowed 20
126 Lark Dr., Apt. D
Carmel, IN 46032
In Sum of
47.38
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1046 reimb. 4239037 47.38 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
2 -Feb 2009
Signature
47.38 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund