215224 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 364931 Page 1 of 1
ONE CIVIC SQUARE LINDSAY WILLARD
CARMEL INDIANA 46032 7345 BRITTANY WAY CHECK AMOUNT: $50.00
,
FISHERS IN 46038 CHECK NUMBER: 215224
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 REIM 50 . 00 GENERAL PROGRAM SUPPL
Carmel 0 Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
$50 gift card for winner of MCC
11/12/2012 The Blue Mile 1096-22 4239039 General Program Supplies 50.00 Weight Loss Challenge
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Lindsay Willard
Address 7345 Brittany Way Nov 14 2012
Check
payable to: City, St, Zip Fishers, IN 46038
Signature: UAM Approved by:
_ Date: 1-/12/2012 Date: t ti
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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.
364931 Willard, Lindsay Terms
7345 Brittany Way
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
11/12/12 Reimb Gift card for winner of Wt loss challenge $ 50.00
- Total $ 50.00
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.
364931 Willard, Lindsay Allowed 20
7345 Brittany Way
Fishers, IN 46038
In Sum of$
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-22 Reimb 4239039 $ 50.00 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
ONov 2012
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund