HomeMy WebLinkAbout220923 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 00350221 Page 1 of 1
ONE CIVIC SQUARE LINDA ACOSTA
CHECK AMOUNT: $477.57
C/O PARKS
?a CARMEL, INDIANA 46032 CHECK NUMBER: 220923
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 REIMB 477 . 57 GENERAL PROGRAM SUPPL
I
Carmel * Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
Z�J13 �Qr�-�l �\-�1 )DB1-10 �IZ39'd3� � ��noc� II•l� ��� - .g-5- � L 5���izsv�
7 a \mat e
5 � � lug1-► D 1U3� n \ 1v� x
DLj ►0$I-10 y23�1'b3� n ``..
All receipts should be attached in the same order as listed above. �jr7
No sales tax will be reimbursed. TOTAL: $ LI 1 • �
Employeen Name(print) A F-\
�((� ` _� �" NT,D
Address 01,711 TlPC 7 a--X� �,C� ` JUN 0 4 2013
Check
payable to: City, St, Zip Oax ,;-�eA "_.........
C S Y:
Signature: �-- Approved by:
Date: 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.
00350221 Acosta, Linda Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
5/31/13 Reimb. Supplies for last day of school $ 477.57
i
Total $ 477.57
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.
00350221 Acosta, Linda Allowed 20
In Sum of$
$ 477.57
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1081-10 Reimb. 4239039 $ 477.57 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
13-Jun 2013
MP
Signature
$ 477.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund