HomeMy WebLinkAbout208225 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
F CHECK AMOUNT: $171.14
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
INDIANAPOLIS IN 46205 CHECK NUMBER: 208225
CHECK DATE: 4/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 REIMB 27.00 GENERAL PROGRAM SUPPL
1081 4343000 REIMB 144.14 TRAVEL FEES EXPENSE
Carmel 0 Clay
Parks &Recreati ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description p Amount Purpose of Expense
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. I TOTAL: I s al L
Employeen Name (print) n�A ,l W�
Sr APR, 1 7 ?012
Address C S�
Check
payable to: City, St, Zip (�,1.(ilVl(it I�D� lS i I LI
Signature: Approved by:
Date: Z- Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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Date of Fund Account Account
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All receipts should be attached in the same order as listed above. I D
No sales tax will be reimbursed. TOTAL: (y
APIA 1
Employeen Name (print) 6( V1/\ 2012
Address 5D s S� By...
Check
payable to: City, St, Zip ZZ C)
Signature: Approved by:
Date: I Date:
I
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/11/12 Reimb. Staff appreciation 27.00
4/9/12 Reimb. NAA conference 144.14
Mileage 2/6 3/7/12
Total 171.14
I 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.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
171.14
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1081 -2 Reimb. 4239039 27.00 1 hereby certify that the attached invoice(s), or
1081 -99 Reimb. 4343000 144.14 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 -Apr 2012
Signature
171.14 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund