HomeMy WebLinkAbout217751 02/26/2013 E CITY OF CARMEL, INDIANA VENDOR: 366982 Page 1 of 1
ONE CIVIC SQUARE CAMILLE NELSEN CHECK AMOUNT: $34.91
;'. ,. CARMEL, INDIANA 46032 C/O ESE
CHECK NUMBER: 217751
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 34 . 91 GENERAL PROGRAM SUPPL
Carmel • Clay I
Parks&Recreate®n
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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 attached in the same order as listed above. 19-34.No sales tax will be reimbursed. TOTAL:
Employee Name(print) A—M I
Address /DO Xo t--
Check
payable to: City, St, Zip 0 //`J L/49033
Signature: t i'd/ ,%L/ Approved by:
t
Date: / �j Date: / J13
i
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
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.
Nelsen, Camille Terms
12026 Eden Glen Dr
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/9/13 Reimb Supplies from Kroger for Princess Ball $ 34.91
Total $ 34.91
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.
Nelsen, Camille Allowed 20
12026 Eden Glen Dr
Carmel, IN 46033
In Sum of$
$ 34.91
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1096-60 Reimb 4239039 $ 34.91 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
21-Feb 2013
Signature
$ 34.91 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund