HomeMy WebLinkAbout212737 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $4.26
CARMEL,INDIANA 46032 2713 HIGHLAND PLACE
INDIANAPOLIS IN 46208 CHECK NUMBER: 212737
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 4 .26 GENERAL PROGRAM SUPPL
Carmel ® Clay
Parks&Recreatioh
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 attach4fd in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
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Employeen Name(print)��(G� pig f
Address';-7t3 PyAc;,: V+D-o dA,�
Check
payable to: City, St,Zip�tyD(
Signature: gk6An.: — Approved by:
Date: LC1R��UI!5 "Z Date: -
Revised 3-2-07 by Business Services; ' ..;
Shared/Fors and Templates/Business service Fors/Employee Exp Reimb Request 2007-3 $ �
AUG
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Welcome to Dunkin' Donuts
Store #345039
Indianapolis, IN
8/17/2012 6:16:46 AM
Eat In
Order Number m 107 pwldlaft
P.O.ash,
Register:1 Tran Seq No: 204107 G.L.# c P rd Ft
Cashier:Ronnie D. Budget
Line uesC►
3 Bx Joe Or i g B 1 nd G 38. 97 puMhft8r 11
1 Bx Joe Dcf �12. 99
Date�7,1�p �
1 Open $ (Item) (4.68)-�► ��q r, pie_ 1
- Sub—Total: $47.28
$4. 26
Total : $51.54
Discount Total : ($4.68)
Change $8.46
Cash $60.00
HEY NEW!
WANT A FREE DONUT WHEN YOU PURCHASE A
MEDIUM OR LARGER BEVERAGE?
Go to www,teildunkin.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: 10'101-45039-0608-1724 AUG 2 2 2012
Enter Validation Code= -"- -.-
Bring receipt with code to redeem offer.
Visit DunkinDonuts.com for
redemption restrictions.
Franchisee: Please use PLU #201
Try our delicious Coffee and Donuts
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
8/17/12 Reimb WB breakfast $ 4.26
Mileage 2/29-3129/12
Total $ 4.26
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
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
f Indianapolis, IN 46208
In Sum of$
I
$ 4.26
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-11 Reimb 4239039 $ 4.26 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
6-Sep 2012
Signature
$ 4.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund