210443 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 366333 Page 1 of 1
ONE CIVIC SQUARE JEFFREY LEE
ei
CARMEL, INDIANA 46032 C/O PARKS
CHECK AMOUNT: $41.02
CHECK NUMBER: 210443
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 41.02 TRAVEL FEES EXPENSE
HANKS FOO VISITING
arnapo l is Zoo
(317) 630 -2001
1pa4 HEM AMOUNT
my 6.00
SUBIOIAL 6.00
SALES TAX 0.00
1 I IAI 6.00
Cash TENDERED 20.00
r,HTiBCiE: 14.00
1:l 55 AM 05/:30/2012
042,592498 1706
Hours of Operation
Hon -Thurs 9am -5pm
r i -SLII I Ho 1 i days 9am -7pm
.1 %tDp 1 Y You r $6. 00
rk i rig r•ece i pt
Iowa rd a
membe rsh i p today
Must be used prior to admission.
Carmel e clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
��3o�28�z jvkj "A 11 Zoo load-( �q' (AVO- P� bivn 4c* &b 7it
All receipts should be attached in the same order as listed above. 6.oa
No sales tax will be reimbursed. TOTAL:
Employeen Name (print) 3r=fr -9*Y I
Check JUN 19 2012
Address Vf5 FAkc C� ¢6S C i
payable to: City, St, Zip CAT +M, t N
Signature: /2. Approved by:
Date: Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
KECEIVED
JUN 20 2012
PRESCRIBED BY STATE BOARD OF ACCOUNTS BY GENERAL FORM NO. 101 11 98 67
f•J 1 MILEAGE CLAIM EP F �'E
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
tOF BOARD. DEPARTMENT OR INSttTUTION)
SPEEDOMETER
DATE FROM TO I RE ADING AUTO MILEAGE
2� IL POINT POINT START FINISH NATURE OF BUSINESS TRAVELED r
PER MILE
5 'So C.V�cu� c�ak. ��u
-Q lvk iw' lls moo i
1) 1 Gw
5 ..a►oStrJ� y
E+ t 3 b K.s Itt •Y� sd eJ�.e. ._Q,_ Geyw�¢� l�oao.• C e.n'1
1 (,.aRa- Stl�. lc Cv 'u Pk
6 t C-- ("A -L-L A&-kA S C ww�r( Flo 3w.
b S Gvt [SrOU k%k'& School ca N'W C.—;w 1 a .N.
AUTO LICENSE NO. TOTALS wi. 3 S 6 Z
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally d e,,after alioWin all just credits
end that no part of the same has been paid.
Date Zot2
>r
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.
Lee, Jeffrey Terms
1452 Trail Creek Ct
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/15/12 Reimb Mileage 5/29 6/5/12 35.02
5/30/12 Reimb Field trip 6.00
Total 41.02
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Lee, Jeffrey Allowed 20
1452 Trail Creek Ct
Carmel, IN 46032
In Sum of
41.02
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO #or INVOICE NO. A.CCT #/TITL AMOUNT Board Members
Dept
1082 -1 Reimb 4343000 35.02 1 hereby certify that the attached invoice(s), or
1082 -1 Reimb 4343000 6.00 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
28 -Jun 2012
Signature
41.02 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund