HomeMy WebLinkAbout220973 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $61.98
CARMEL, INDIANA 46032 5057 E 71ST STREET
INDIANAPOLIS IN 46205 CHECK NUMBER: 220973
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 REIMB 61 . 98 GENERAL PROGRAM SUPPL
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
4 S�,;b lb ya3q o3 15 8- S}td4 OA v\
�s 0*-
CK - 1
All receipts should be attached _adme order as listed above.
No sales tax will be reimbursed. TOTAL: $ s �'T�T��
I .�8
Employeen Name(print) C JUN G 4 2013
Check
Address CjDCj—] 'C., -1)� .
LBY'
payable to: City, St,Zip"f'n A ana 1':L I K LI)
Signature: 7722) Approved by
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Date: 15) 1I I Date: —V "I
Revised 3-2-07 by Business Services;
Ow��YVA
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'rkn d of serfice,units, price performed, dates service rendered, by
whom, rates per day, number of h per
Payee Purchase Order No.
Terms
358408 Buckingham, Tiffany
5057 E 71 st St
Indianapolis, IN 46205
Invoice Invoice
Description PO# Amount
Date Number (or note attached invoice(s)or bill(s)) 61.98
5/24/13 Reimb. School staff lunch /Subway
Mileage 4/30-5/7/13
Total $ 61.98
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 71st St
Indianapolis, IN 46205
In Sum of$
$ 61.98
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1081-2 Reimb. 4239039 $ 61.98 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
Signature
$ 61.98 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund