HomeMy WebLinkAbout178181 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CHECK AMOUNT: $19.48
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE
INDIANAPOLIS IN 46220 CHECK NUMBER: 178181
CHECK DATE: 10/1412009
DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DE
1046 4239039 19.48 GENERAL PROGRAM SUPPL
Carmel o Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
C— '\j j �Ca -i O�� `t23 �U�'� c A SvnSCr
All receipts should be attached in the same order as listed above. I
No sales tax will be reimbursed. TOTAL:
l�.J
11
Employee Name (print) Vey �lGm\rV GLL SEP 2 4 8 2009
Address LO
Check n
payable to: City, St, Zip (N\ G�V\o.�� 1 V �LO 2 2
Signature: U Approved by:
Date: �2� 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.
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
9/16/09 Reimb. Sunscreen 19.48
Total 19.48
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.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
19.48
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept INVOICE NO. ACCT #TTITL AMOUNT
1046 Reimb. 4239039 19.48 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
7 -Oct 2009
Signature
19.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
cvs
pharr
for all the ways you care
13090 PETTIGRU DRIVE, CARMEL, IN
PHARMACY: 733 8608 STORE:
REG #02 TRAN 44080 CSHR 4773790 SSIR111367
CxtraCare Card 1; nnm*89
1 BB SPRT BLOCK 82 9.49T
1 BB ULTRAM SP 62 9.99T
2 ITEMS
SUBTOTAL 19.48
IN 7.0 TAX 1.36
TOTAL 20.84
DEBIT 20.84
*y* *7503 MS
CFIA`i' E
.00
l�lll II I I IIIiI� III Illlllllii II III
5136 7925 9408 0023
RETURNS WITH RECEIPT THRU 11/15/2009
SEPTEMBER 16, 2009 1:59 PM
TO ENSURE YOU GET ALL THE, OFFERS ANI1
INFORMATION AVAILABLE SPECIFICALLY
�FOR UPDATE YOUR EXTRACARE
INFORMATION AT EITHER
CVS.COM OR CALL 1- 800- SHOP-CVS.
Flu shots every day here at
MinuteClinic! No apPointmenl needed.
minuteclinic.com 1- 888-FI -U SHOT
THANK YOU. SHOP 24 HOURS AT CVS.COM
ExtraCare Card balances as of 06/30
SLIMMER 2009 SPENDING: 5.28