172399 05/13/2009 a CITY OF CARMEL, INDIANA VENDOR: 361255 Page 1 of 1
0 ONE CIVIC SQUARE CARRIE KEAVENEY CHECK AMOUNT: $40.99
CARMEL, INDIANA 46032 13789 FIELDSHIRE TERRACE
WESTFIELD IN 46074 CHECK NUMBER: 172399
CHECK DATE: 5/1312009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 40.99 GENERAL PROGRAM SUPPL
car e CD Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
4/28/2009 mei'er 47.400.22C 4239039 General Program Supplies $40.99 Pro ram participant dinner
T_
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. T $4
Employee Name (print) Carrie Keaveney MAY 5 2009
4
Address 13789 Fieldshire Terrace
Check BY:.........
payable to: City, St, Zip Westfield IN 46074
Signature: ea tz" 6q Approved by: Tee RAE
Date: 5/1 /200 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.
361255 Keaveney, Carrie Terms
13789 Fieldshire Terrace
Westfield, In 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4128109 Reimb Program partcipant dinner 40.99
Total 40.99
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
361255 Keaveney, Carrie Allowed 20
13789 Fieldshire Terrace
Westfield, In 46074
In Sum of
40.99
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 Reimb 4239039 40.99 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 -May 2009
Signature
40.99 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund