206498 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 364931 Page 1 of 1
f ONE CIVIC SQUARE LINDSAY WILLARD
CARMEL, INDIANA 46032 7345 BRITTANY WAY CHECK AMOUNT: $50.00
FISHERS IN 46038
CHECK NUMBER: 206498
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 REIMBURS 50.00 GENERAL PROGRAM SUPPL
Carm a
Parks &Recreation
a
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
$50 gift card for the winner
1.31.2012 The Runners Forum of Carmel 1096 a 4239039 General Program Supplies $50.00 of the Winter /Spring 2012
MCC Weight Loss
Challenge
k
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
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Employee Name (print) Lindsay Willard
FEB 0 2 1011
Address 73_45 Brittany Way
Check
payable to: City, St, Zip Fishers, IN 46038
Signature: a V9 c.�J Approved by
Date: 1.31.2012 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Administrative \Forms \Staff 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.
364931 Willard, Lindsay Terms
7345 Brittany Way
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/31/12 Reimb Gift card for winner of Wt loss challenge 50.00
Total 50.00
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.
364931 Willard, Lindsay Allowed 20
7345 Brittany Way
Fishers, IN 46038
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1096 -22 Reimb 4239039 50.00 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
9 -Feb 2012
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund