208353 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 357976 Page 1 of 1
0 ONE CIVIC SQUARE BENJAMIN JOHNSON CHECK AMOUNT: $151.31
CARMEL, INDIANA 46032 11182 HARRISTON DRIVE
FISHERS IN 46037 CHECK NUMBER: 208353
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 151.31 TRAVEL FEES EXPENSE
Carmel Clay k %w�un Ccr� U-
Parks &Recreation Apr 2`4, 20(2-
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above. 3
No sales tax will be reimbursed. TOTAL:
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Employeen Name (print) Oj J p i
APR It r 2 12 U
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Check Address
payable to: City, St, Zip
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Signature: Approved by: 1
Date: I `Q 1 Date: I I 12—
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.
357976 Johnson, Ben Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/16/12 Reimb Natl Afterschool Assoc conf 151.31
Total 151.31
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
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
357976 Johnson, Ben Allowed 20
i
In Sum of
151.31
ON ACCOUNT OF APPROPRIATION FOR
T08 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 Reimb 4343000 151.31 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
1 1-1
Signature
151.31 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund