HomeMy WebLinkAbout215982 01/09/2013 ��. CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $47.97
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
INDIANAPOLIS IN 46205 CHECK NUMBER: 215982
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 47 . 97 GENERAL PROGRAM SUPPL
-2� 6-�q CT
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Einstein Bros Bagels
Store # 2683 �(
9598 Allsionville Rd�,A,`
317-577-988
;.t
ToGo 1.04 �Q
Host: Manager 12/12/2012
ToGo104 5:55 AM
10005
Order Type: TOGO
House Coffee Joe ToGo 15.99
Van Hzlnt Coffee Joe ToGo (2 @15.9 31 .98
Subtotal 47.97
Bev Tax Type Tax 4.32 ;
TOGO Total 52 . 29 '
waxoXXXXXXXXXXX00 52.29
Auth:112605
SIGNATURE
• I
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Validation Code
--- Check Closed ---
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
f l receipts should be attached in the same order as listed above. q sales tax will be reimbursed. TOTAL: Ts `i
Employeen Name(print) o U n �1 DEC
Address �S-7 E 31 S� St Q 2012
-J
Check BY:
payable to: City, St, Zip frlj
a� V7r,)OD)1`(�
Signature: 44 )ft/t--� Approved-by:
Date: - - 7�1 Date:
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3
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.
358408 Buckingham, Tiffany Terms
5057 E 71st St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/12/12 Reimb. Site celebration $ 47.97
Mileage 9/12 - 11/12/12
Total $ 47.97
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.
358408 Buckingham, Tiffany ` Allowed 20
5057 E.71 st St
Indianapolis,;IN 46205 .
***NEW ADDRESS In Sum of$
$ 47.97
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-2. Reimb. 4239039 $ 47.97 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
3-Jan 2013
Signature
$ 47.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund