176862 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 360861 Page 1 of 1
ONE CIVIC SQUARE TERRY MYERS
CARMEL, INDIANA 46032 C/O PARKS DEPT CHECK AMOUNT: $75.93
CHECK NUMBER: 176862
CHECK DATE: 9/2/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO DESCRIPTION
1047 4238000 39.99 SMALL TOOLS MINOR E
1047 4238900 35.94 OTHER MAINT SUPPLIES
Carmel a Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
�2
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:• J
Employee Name (print) /err
Address 1 3 r �V j e ccJ
Check
payable to: City, St, Zip
Signature: roved by:
Date: 0 1 Date:
Business Services Division, Revised 7 -7 -08
FILE: Shared\Ad min istrative\Forms\Staff Forms\Employee Exp Reimb Request
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receip Line Budget Description Amount Purpose of Expense
All receipts should be attached in the same order as listed above. 3�
No sales tax will be reimbursed. TOTAL:
l
Employee Name {print} I I q�
f
Address v L V CO-) ji
Check
payable to: City, St, Zip h v� 1,7
Signature: Approved by:
Y
Date:
Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrative%Forms \Staff Forms \Employee Exp Reimb Request
ACCOUNTS PAYABLE VOUCHER
CrY 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.
Myers, Terry Terms
113 Parkview Dr Date Due
Danville, IN 46122
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
816109 Reimb. Autozone /Buffer 22387 F 39.99
815109 Reimb. Autozone/Bo n nets for buffer 22370 F 35.94
`total 75.93
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.
Myers, Terry Allowed 20
113 Parkview Dr
Danville, IN 46122
In Sum of
75.93
ON ACCOUNT OF APPROPRIATION FOR
104 Program fund
.PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 Reimb. 4238000 39.99 1 hereby certify that the attached invoice(s), or
1047 Reimb. 4238900 3 5.94 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
27 -Aug 2009
Signature
75.93 Accounts Payable Coordinato
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund