221084 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 360925 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HOLDER
CARMEL, INDIANA 46032 5716 DURHAM CASTLE CT APT 137 CHECK AMOUNT: $232.06
INDPLS IN 46250
CHECK NUMBER: 221084
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 REIMB 189 . 95 GENERAL PROGRAM SUPPL
1081 4343000 REIMB 42 . 11 TRAVEL FEES & EXPENSE
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
51a�11 c �� - tia3 ao3 iL UC le-C&t a ea �
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print) f 1L���` JUN 44 2013
Address ��C�I �7J ���CQ . s JUN I I
Check .
payable to: City, St, Zip ---
Signature: `` n I Approved by:
Date: 5 ia `� Date:
v
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Invoice No: 792851
Invoice Date: May 28, 2013
Stare Code: 2280
Store: 116th and Keystone
INVOICE
Billing Information Pick-up Information
Carmel Clay Parks &Rec.
Orchard Park Elementary School Pick-Up Date: 05/28/2013 (7:00 - 7:15 AM)
10404 Orchard Park Dr. S.
Indianapolis, IN 46280 Jennifer Holder
Carmel Clay Parks &Rec.
Phone: (317)679-9867 Phone: (317) 679-9867
Payment Method: Credit Card
VISA(...9223) Exp; 03/14
Auth z: 621158 Amt: 207.05
Order entered by: Online Printed: 06/12/2013 12'56 PM MDT
5 Mixed Bagels and Sweets Noah box(& For the Group 5 37.99 189.95
10 Blueberry Basel
10 Chocolate Chip Bagel
10 Cinnamon Raisin Bagel
--. -------------....
5 Cinnamon Sugar Bagel
...........
5 Good Grains Bagel
iS Plain Bagel ----------
----
5 Sesame Bagel
1 Garden veggle Shmear
1 Honey Almond Shmear
2 Reduced Fat Shmear(25%less fat)
3 strawberry Shmear
1 Onion and Chive Shmear
2 Regular Plain Shmear.
5 Chocolate Chip Coffee Cake
5 Banana Nut Muffin
5 Blueberry Muffin ._. ....
5 Chocolate Chip Muffin
5 Blueberry Scone
5 Cinnamon Scone
15 Cinnamon Walnut Strudel
1 Brownie Box Half Dozen Sweets for the Croup S 12.99 12.99
6 Brownie
TSubTotal 202.94
For Corporate Accounts only please send Web Promo Discount: (512.99)
payment to: Tax: 17.10
EINSTEIN NOAH RESTAURANT GROUP INC Catering Orders and Questions: Total: 207.05
NW 6042 J.800.BAGEL.ME (224-3563)
PO Box 1450 Visa: (207.05)
Minneapolis, MN 55485-6042 ^� Refund: 17 1.0
Balance pun: 0100
Web Promo: 1 rree Brownie Box Half Dozen for subtotal >=150.00 Accepted
Delivery minimums and the applicable taxes for the order may vary per locatlon and may be adjusted prior to your
final charge. Please contact the store your order was placed at for more details.
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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
I `
Pb-Lo posy-) a ek e 9) � S 00
1�Cf U Z�C� �t�sl-�l�l �t 3X13 \ � 8134 - 11 Mnor-`
r Akin
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print) ��\1���L� I--�do&C JUN 0 2013
Address la,�y �� `"I2rd, St ��-
Check
payable to: City, St, Zip -T(-) �0 oL WN I
r
Signature: ti �� Ll 9�C� Approved by:
Date' I Date: 3 i3
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
F
i
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.
360925 Holder, Jennifer Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
4/17/13 Reimb Travel expenses for NAA Annual conference $ 42.11
5/28/13 Reimb OPE Teacher breakfast $ 189.95
I
Mileage 7/6 - 11/30/10
Total $ 232.06
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.
360925 Holder, Jennifer Allowed 20
In Sum of$
$ 232.06
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 42.11 1 hereby certify that the attached invoice(s), or
1081-6 Reimb 4239039 $ 189.95 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-Jul 2013
Signature
$ 232.06 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund