208476 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN STORMS
CARMEL, INDIANA 46032 CHECK AMOUNT: $38.97
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CHECK NUMBER: 208476
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 38.97 GENERAL PROGRAM SUPPL
Welcome to Dunkin' Donuts
Store #345039
Indianapolis, IN
4/13/2012 6:25:31 AM
Drive -Thru
Order Number: 922
Register:5 Tran Seq No: 121922
Cashier:Andrew V.
3 Bx Joe Orig Bind 38.97
Sub. Total: $38.97
Tax: 3.51
Total: $42.48
Discount Total: $0.00
Change $0.00
Master Card: $42.48
HEY AMERICA!
WANT A FREE DONUT WHEN YOU PURCHASE A
MEDIUM OR LARGER BEVERAGE?
Go to www.telidunkin.com on your
.computer or mobile device in the next
3 days and tell us about your visit.
Te invitamos a participar en
nuestra encuesta.
Survey Code: 92204 45039 -0604 -1328,
Enter Validation Code:
Bring receipt with code to redeem offer.
Visit DunkinDonut5.cOm for
redemption restrictions.
Franchisee: Please use PLU #201
Try our delicious Coffee and Donuts
Carmel Clay
Parks &Recreate ®n
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.
No sales tax will be reimbursed. TOTAL:
Employeen Name (print) ft� awyl SA&f Ms
r['� A 1,TO 1
Address Sb IN t ot�I Cyy-o Ph, -y r Or APR 1
Check is 201
payable to: City, St, Zip j r a� p D
er
Signature: Approved by:
Date: f 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.
363382 Storms, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/13/12 Reimb Coffee for site celebration 38.97
Mileage 3/1 3/28/12
Total I 38.97
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.
363382 Storms, Meagan Allowed 20
In Sum of
38.97
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1081 -7 Reimb 4239039 38.97 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
38.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund