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211480 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 362215 Page 1 of 1 Q � ONE CIVIC SQUARE BROOKE TAFLINGER CHECK AMOUNT: $80.00 CARMEL, INDIANA 46032 11008 BROADWAY ST INDPLS IN 46280 CHECK NUMBER: 211480 CHECK DATE: 7/31/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4358300 REIMB 80 . 00 OTHER FEES & LICENSES Carmel • Clay Parks&Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense �'`�� la NC. C. l o°l y-�S�3�0 O-�t.,o�.F�� L�carte � OU•� (1�11�1 � . All receipts should be attached in the same order as listed above. Q No sales tax will be reimbursed. TOTAL: O�•� Employee Name (print) Address\T0% Check 1 payable to: City, St, Zip �� `A� Signature: Approved by: IV Date: - 1?j` `p� Date: J Business Services Division,Revised 7-7-08 P,--F,C. T F_,.?:.,.,a FILE: Shared\Forms\Business Services\Employee Exp Reimb Request JUL 1 7 2012 [BY: Account Activity Page 1 of l CHASE !i fiwi66��r' I CREDIT CARD(...5579) Trans Date Post Date Type Description Amount Q 07/06/2012 07/08/2012 Sale NCTRC $80.00 845-6391439,NY 109560000 US Online, Mail,or Telephone transaction littps://cards.cliase.com/cc/Account/Activity/221441990 7/12/2012 O ya"iClie X/YLalU9?11y'al, 3-r r_ Tylookeo TafCinger a 1"0,6 wwt 11re ceixCt1*cal o1)�, ll e �aGror�a��ouunaco�/oot gze^111i6MAG",RecAeeaG1,0191{one r�acafa�z �^-�'-�t aii�rrur�ate Cie c>',e�r�ur.Caart� I��s Certified Therapeutic Recreation Specialist® CTRS° NCTRC 5'281; 06/30/2012 Deborah Robinson,CTRS Bob Riley,Ph.D.,CTRS Certification Number Expiration Date Chair of the Board of Directors Executive Director I 1981 ©2010 National Council for Therapeutic Recreation Certification"INCTflC`i.All rights reserved.This document and the NCTRC Trademarks,including the marks"CTRSand y `Certified Therapeutic Recreation Specialist^"may only be used in accordance with the rules and standards of NCTRC.This document must be returned immediately upon request by NCTRC. INV 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. 362215 Taflinger, Brooke Terms 11008 Broadway Ave Indianapolis, IN 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 7/6/12 Reimb. TRS certification annual fee $ 80.00 Mileage 4/18/11 Total $ 80.00 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. 362215 Taflinger, Brooke Allowed 20 11008 Broadway Ave Indianapolis, IN 46280 In Sum of$ $ 80.00 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 Reimb. 4358300 $ 80.00 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 26-Jul 2012 P)&u/nruu Signature $ 80.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund