179689 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $25.77
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE
INDIANAPOLIS IN 46220 CHECK NUMBER: 179689
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239039 REIMB 25.77 GENERAL PROGRAM SUPPL
Wa I m a r t
Save money. Live better.
Walmart
MANAGER RICK FRANCIS
317 202 9720
INDIANAPOLIS, INDIANA
ST# 2787 OP# 00004884 TE# 25 TR# 04439
MAKEUP KIT 002316819541 3.50 T
LIC WOMEN 003269204920 17.50 T
VOIDED ENTRY
LIC WOMEN 003269204920 17.50 -T
BIG MIX 002800023101 FLT_3
MIXUPS 3202 007920011967 F <�OD�X
TAX 1 7.000 1.51
TOTAL 23.01
CASH TEND 24.00
CHANGE DUE 0.99
ITEMS SOLD 3
TC# 3777 5856 8670 4780
IIII IIII II IIIII II I II.IIIIIIIII��II III II
We want you to pay the lowest price.
Ask about our price match policy.
10/29/09 21:08:48
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
l0 28 `1 �c:r (Oq -q 2 3�O3`' r^ �c�S rS� C
f No receipts should be attached in the same order as listed above. F�
sales tax will be reimbursed. TOTAL: cX
Employee Name (print) I) �r- 1yTWY S u K
n NOV 0 5 2009
Address
Check t BY:
payable to: City, St, Zip �(aj c, T\ G �C 0 5 r V 4 (.0 Z
Signature: Off Approved by:
Date: 1 Date: I� O 3 U
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.
358411 Hammons, Jennifer Terms
634 Northview Ave Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/3/09 Reimb. Program supplies WC 25.77
Total 25.77
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
i
Voucher No. Warrant No.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
25.77
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept ept
1046 Reimb. 4239039 25.77 i 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
19 -Nov 2009
Signature
25.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund