208264 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 363065 Page 1 of 1
ONE CIVIC SQUARE JAMES DOWELL
CARMEL, INDIANA 46032 C/O PARKS ESE CHECK AMOUNT: $716.79
CHECK NUMBER: 208264
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 716.79 TRAVEL FEES EXPENSE
ttiraD� R OtAtt lOAeb Oe t000WIfD Q�G rqY PO. 1W (1tD1J
MILEAGE 'CLAIM
ON ACCOUNT OF AMOPWAMON NO: FOR
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pine nom TO MMING AUTO
POW POINT BTAR FntiBH NATU6Y OF HU9II7E88 TA O
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SPENDOM>sM HEADING ad== am io be peed only when distance behman points eaanot be determined by fired mileage or oifioial highway map.
Pursuant to" provisions and penalties of Chtyter 168, Acts 1993, I hereby certify that the foregoing account is lust and correct, that the amount claimed In is y d after allovdng just credits
end that no wart the same has been paid.
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Dame FROM TO Rp�p AUTO BULSA(i6
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AUTO LICENSE NO. TOTS U- i 5 .1 5
SPMOMI M READING columns axe to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provide= and ponalttes of Chapter 188, Acts 1983, I hereby certify that the foregoing account is Just and correct, that the amount claimed is to du after allowing Just credits
and that ao the same has been paid.
Dat
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79 0 W)T
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2012
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Carmel e Clay 1\WUonclk C� a l
Parks &Recreate ®n try Ica, P� rtx
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Employee Expense Reimbursement Request AV 2 y 2012
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
I wlI;- R4Y)e('ican R'Ic Rqi' �2)HZ000 rovekFees4 ens(f s s A
MCb 0QI(�s l\ t I k calf 9, 6 1J:eC,140 -SV
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U Qor\ 'PG; I3, v I&CC, kPGSd—
�113 39
yil��a- UO�oGL, I i 1 73 CXn
TexG(, lJA-a�'of` 1 1 I 7, a lJ D nn�t
a �le, CI.�e1 <es e I t I )3, D 0
All receipts should be attached in the same order as listed above. a
No sales tax will be reimbursed. TOTAL:
Employeen Name (print Orf)e APR 1 2012 iU)
Address Ii -ISO 7-
Check A. By..
payable to: City, St zip "Tr Gy\ Uo� AI �I� L 2 2
Signatu �7 Approved by:
Date: I C I I o`- Date: Z
I
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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
1 Q �13�13coO �vel�eessa� Z 5
G4 exG(��(�c�n5 ��t> h �nscs
1 4 1 1�► 2 L one S4�r- SJ 4 1, 0 K 6 nc k
Z7
2, 00 M JanS a'�G�Or
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: I s l J
X5 (0 1
Employeen Name (print) ��Me S 7
Address '15 G o Q t �cve�Z 1 1Z
Check Jay,
payable to: City, St, zip l o k aoo c-Dk'�s 7n 1 -14 2g2 ..............u...
Signature: Approved by:
Date: Date:
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.
363065 Dowell, James Terms
14328 Banister Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/16/12 Reimb. Mileage 10/17/11 4/12/12 459.78
419/12 Re imb. NAA.conference 257.01
Total 716.79
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.
363065 Dowell, James Allowed 20
14328 Banister Dr
Noblesville, IN 46060
In Sum of
716.79
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -3 Reimb. 4343000 459.78 1 hereby certify that the attached invoice(s), or
1081 -99 Reimb. 4343000 257.01 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
716.79 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund