208325 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 360925 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HOLDER
CARMEL, INDIANA 46032 5716 DURHAM CASTLE CT APT 137 CHECK AMOUNT: $123.57
INDPLS IN 46250
CHECK NUMBER: 208325
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 123.57 TRAVEL FEES EXPENSE
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request l2-
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
y 1 /12 AVne'\co.Y, Z A C
y 1 2 P- 1 ow Cc \c, r S'w' -Nk (r o. o o e.
�I 13112 Java oaf 2
X152-
1� 12 2.D GO �o
i2 $2-S, o c cV\,Q-caa b,
7. i1
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employeen Name (print)
Address dqI W `1 2Y)6 V\ O R 1 7 201
Check
payable to: City, St, Zip
Signature: G Approved b
Date: \'Z Z 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.
360925 Holder, Jennifer Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/12/12 Reimb NAA conference 123.57
Mileage 7/6 11/30/10
Total 123.57
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.
360925 Holder, Jennifer Allowed 20
In Sum of
123.57
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 Reimb 4343000 123.57 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
19 -Apr 2012
Signature
123.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund