HomeMy WebLinkAbout173245 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $145.45
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
INDIANAPOLIS IN 46205 CHECK NUMBER: 173245
CHECK DATE: 611012009
DEPARTMENT A CCOU N T PO N I NVOICE NUMBER A MOUNT DESCRI
4239037 29.95 CLUB ACTIVITY SUPPLIE
1046 4343004 115.50 TRAVEL PER DIEMS
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Carmel 0 Clay
'arks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above. 2� I
No sales tax will be reimbursed. TOTAL:
Employee Name (print) &J O 4v�
Address 1 51 �0 -Prt M (osse AVc L MAY 2 6 2009
Check
payable to: City, St, Zip �M(O -VICA Pot tS I Lj (02Q S_
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Signature: c, fl Approved by:
Date: �j l S �U� Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff Forms%Empioyee Exp Reimb Request
A pe� "lo
Carmel e Flay
Park &Re rent oh
Com pany Name &Address: Ship To: Contact Information:
Making Friends. com The Monon Center Attn: Tiffany Buckingham Name: TiffanyBuckingham I Adventures In Art
1235 Central Park Dr, E Phone: 698 -6579
Carmel, IN 46032 Fax:
Customer Number: nla Purchase Order Number: Key Code: nla
Pg item Number Qty'. Description Unit Total 'Price Purpose -(e.g. club richer store, academics)
MF -1222 5 foamie weaver $4.99 24.95 Adventures In Art
Notes: II� hh Subtotal 24.95
��`lV S&H &A- d
TOTAL 24.95 1 9 6
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CARD TRANSACTION
05/18/09, O 5:17 $29.95 MAKING FRIFNDS.COM, KINGS PARK,
L NY FROM CARD 5424320178833827
C U S T O M E R C O P Y C U S T O M E R C O P Y C U S T O M E R C O P Y
Making Friends.com PACKED
1 Ivy Road COUPON
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Kings Park, NY 11754 I GET $10.00 OFF
YOUR NEXT ORDER OIL $100 OR MORE
1- 800 559 -1182 631- 979 -7331 INSPE EQ 13Y
Customer Service Email: Cannot he combined with any otheroiicr.
m,ak %ngfr @optonl�ne net I Enter c6uport codes TFNLESS
I COUPON
Thank you for your order! L,
Returns can be made within 30 days of purchase on unused /unopened merchandise. Close outs and special orders
cannot be returned. Shipping charges are not refundable. Any additional shipping charged to MakingFriends.com by the
carrier will be deducted before the refund is made. Please include a copy of this invoice with the return.
Order #101040 (0511312009 at 09:05:43 PDT)
Ship To: Bill To:
Name: tifFANY BUCKINGINGHAM Name: tifFANY BUCKINGINGHAM
Email Address: tBUCKINGINGHAM @carmelclaypark.com Email Address: tBUCKINGINGHAM @carmelclaypark.com
Phone Number: 3176986579 Phone Number: 3176986579
Fax Number: Fax Number:
Company: Company:
Address: 5130 primrose ave Address: 5130 primrose ave
indianapolis, IN 46205 indianapoiis, IN 46205
US US
Code Product Quantity Price /Ea. Total
MF -1222 Foamie Weavers 6 Pack 5 $4.99 $24.95
Colors: White
Shipping: Economy (Allow 2 Weeks): $5.00
Sales Tax: $0.00
Total: $29.95
Additional Information
1. Hold Entire Order Until Complete
3. Contact by Email
4. Yes, I Agree to the Terms and Conditions
5. June 1st the latest
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JUN 0 2 2009
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PRrSCAIM BY STATE BOARD Or ACCOUNTS GrXFRPL FORM RC. 101 (1W4)
MILEAGE CLAIM �t
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lGOVFANNENTAG UNIT} ON ACCOUNT OF APPROPRIATION NO. FOR
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POINT POINT START FINISH TRAVELED PER MI
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AUTO LICENSE NO. TOTALS
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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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after afiowing all just credits
and that no part of the same has been paid
X'0
Date
V� .0e
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5113109 Reimb. Adventures in Art Camp supplise 29.95
5128109 Reimb. Mileage 513109 5128109 115.50
Total 145.45
I 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.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
145.45
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE N0. ACCT WTITILE AMOUNT Board Members
Dept
1046 Reimb. 4239037 29.95 1 hereby certify that the attached invoice(s), or
1046 Reimb. 4343004 115.50 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
4 -Jun 2009
Signature
145.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund