210503 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
0 ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $193.64
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
INDIANAPOLIS IN 46208 CHECK NUMBER: 210503
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 24.64 GENERAL PROGRAM SUPPL
1082 4343007 169.00 FIELD TRIPS
00 bwv-
Sole 1 ransaction
MCCORMICK'S CREEk SIATE PARK
256 MCCORMICK'9 (.REEK PARK RD
t SPENCER, IN 47960
k 6,19 %2012 11:13:213 AM
'TSRNINAL DLIROF00072
RECEIPT It 3568960360
i
-AUTH CODE 121738
Payment %p VI
Transaction total`:. S 66.00
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THANK YOU FOR YG-i� PAIRONAGE.
PLEASE CWE i,6AIN!
VISIT US ONLINE AT:
WWW.IN.GOV 0NR
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THANK YOU FOR VISITING
INDIANA STATE MUSEUM
(317) 232 -1637
QTY ITEM A MOUN T
5 MUS GRP A 27.50
36 MUS GRP C 126.00
41 LUNCH ROOM 0.00
SUBTOTAL 153.50
SALES TAX 0.00
TOTAL 153.50
GIFT CT 6.00
CHANGE 0.00
10:42 AM 06/14/2012 001:362306 125
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THANK YOU FOR 'VISITING
INDIANA STATE MUSEUM
(317) 232 -1637
QT ITEM AM OUNT
5 MUS .GRP A 27.50
36 MUS GRP C 126.00
41 LUNCH ROOM -0.00
SUBTOTAL 153.50
SALES TAX 0.00
TOTAL 153.50
GIFT CT 46.50
CHANGE 0.00
10:42 AM 06/14/2012 001:362305 125
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THANK YOU FOR 'VISITING
INDIANA STATE MUSEUM
(317) 232-1637
XXXXXXXXXXXX7313 Ye
MCTKT EXPIRES 11/12
APPROVAL 478579
QTY ITE 'AM O U NT
5 MUS GRP A 27':50
36 MUS GRP C 126.00
41 LUNCH ROOM 0.00
SUBTOTAL 153.50
SALES TAX
AMOUNT CHARGE 101.00
10;43 AM 05/14/2012 001;362307 125
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Wal mart
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ve money. Live better.
317 823 1054
MANAGER MIKE ELMORE
10735 PENDLETON PIKE
INDIANAPOLIS IN 46236
STN 3529 OPN 00006471 TEN 10 TAN 05995
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FLOAT 009687720030 1.16 X
FISHHOOK 004770860248 1.16 X
FISHHOOK 004770860248 1.16 X
FISHHOOK 004770860247 1.16 X
FISHHOOK 004770860247 1.16 X
FISHHOOK 004770860248 1.16 X
FISHHOOK 004770860247 1.16 X
SPL SHT 3/0 003877503129 1.76 X
R SPLIT SHOT 008394105770 1.56 X
R SPLIT SHOT 008394105770 1.56 X
SPL SHT 310 003877503129 1.76 X
SPL SHT 3/0 003877503129
SUBTOTAL 24.64
TAX 1 7.000 8
TOTAL 26.36
DEBIT TEND 26.36
CHANGE DUE 0.00
EFT DEBIT PAY FROM PRIMARY
26.36 TOTAL PURCHASE
ACCOUNT N 7313 S
REF 216900329786
NETUORK ID. 0074 APPR CODE 822721
TERMINAL 51046980
06/17/12 14:19:11
ITEMS SOLD 19
TC# 6196 5141 5651 9497 3746
VIII IIIIIIIII (III IIII III IIIIIIIIIIIIIII VIII IIIIi 111 IIII
"Like" Ualnert an Fecebook
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06/17/12 14:19:13
P r9 z M C C lO IC t K -z 7 S CREEK
STATE PARK
wiS RECEIPT
06/19i,'u12 11:17AM 0001
000000 #4002
34 $2.00
WALK Ih $68.00
CHARGEI $68-00
Cannel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
14. 1'2- i tin 5T^T sEUtA 10k 3 4 DO f e T
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: Q
Emptoyeen Name (print) �11
Address 27 1 +31 (,-(A i A-� PI, AC.i✓_ J UN 2 0 2012
Check
payable to: City, St, Zip (1 "OIA T M,
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
Carmel Cray
Parks &Recreati ®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
6/17/2012 Wal -Mart 82 -3 4239039 Supplies 24.64 Camp Supplies
6/19/2012 McCormick's Creek State Park 82 -3 4343007 Field Trip 68.00 Bus Entry Fee
l All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $92.6
Employee Name (print) Nikeesha Pittman
Address 2713 Highland Place
Check
payable to: City, St, Zip I dji na olis, IN 46208
i
Signature: 4 Approved by:
Date: 6/19/2012 Date: v 12 t
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administrative \Forms \Staff Forms \Employee Exp Reimb Request
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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/14/12 Reimb Indiana State Museum Field trip 101.00
6/17/12 Reimb Camp supplies 24.64
6/19/12 Reimb Bus ent^i -fee 68.00
Mileage 2/29 3/29/12
Total 193.64
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
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
193.64
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE N0. ACCT #!TITLE AMOUNT Board Members
Dept
1082 -3 Reimb 4343007 101.00 1 hereby certify that the attached invoice(s), or
1082 Reimb 4239039 24.64 bill(s) is (are) true and correct and that the
1082 -3 Reimb 4343007 68.00 materials or services itemized thereon for
which charge is made were ordered and
received except
28 -Jun 2012
Signature
193.64 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund