HomeMy WebLinkAbout218381 03/25/2013 CITY OF CARMEL, INDIANA VENDOR: 364750 Page 1 of 1
i ONE CIVIC SQUARE JESSICA BALLINGER CHECK AMOUNT: $95.00
CARMEL, INDIANA 46032 10830 TOOLEY CT
«o� APT IF CHECK NUMBER: 218381
INDIANAPOLIS IN 46234
CHECK DATE: 3/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 95 . 00 GENERAL PROGRAM SUPPL
Carmel e Clay
Parks&Recreati®n
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
311 IIIE C�Aba iC'IsA 10 tj9LS903cl 1 S.00) ✓neek'lj.
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $ CFIVPD
Employeen Name(print) ��ss:�. \���� MAR 15 2913
i
Address E . CO LAS;O N
I
Check -
payable to: City, St,Zip pc„r,\}\\\t
Signature: - Approved by:
Date: 3 `I I I.� Date: – —�3
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.
364750 Ballinger, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/1/13 Reimb Qdoba Staff meeting $ 95.00
Mileage 11/5-12/17/12
Total $ 95.00
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.
364750 Ballinger, Jessica Allowed 20
In Sum of$
$ 95.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-10 Reimb 4239039 $ 95.00 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
21-Mar 2013
Signature
$ 95.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund