HomeMy WebLinkAbout219557 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
` ONE CIVIC SQUARE TIFFANY BUCKINGHAM
CARMEL, INDIANA 46032 CHECK AMOUNT: $65.83
5057E 71ST STREET
4 oN�o INDIANAPOLIS IN 46205 CHECK NUMBER: 219557
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 65 . 83 TRAVEL FEES & EXPENSE
Carmel ® Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on recei t # Line# Bud et Description Amount Purpose of Expense
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: Ts �O
Employeen Name(print)
Check Address
i
payable to: City, St, Zip If 1 (�V (�`It r I I� �l(D ZZ
Signature: Approved by: 2
Date: ( Date: 1 J
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 71 st St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/15/13 Reimb. NAA Conference expenses $ 65.83
1
Mileage 11/14/12-2/15/13
Total $ 65.83
I 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
In Sum of$
$ 65.83
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT
1081-99 Reimb. 4343000 $ 65.83 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
18-Apr 2013
Signature
$ 65.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund