HomeMy WebLinkAbout233050 05/28/14 a`,' v,gyfr CITY OF CARMEL, INDIANA VENDOR: 358411
® ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $*******329 28*
_� CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK NUMBER: 233050
M�TON.�` INDIANAPOLIS IN 46220 CHECK DATE: 05/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 329.28 TRAVEL FEES & EXPENSE
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PRESCRIDED 9Y STATE BOARD OF ACCOUNTS aENF,RAL YOAM 110.101(1966)
MILEAGE CLAIM vel �- �Gt(y�rn QY1C
CCp�z_ TO
(..N.ENTAL.1T) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMWff OR INSTITUTION)
SPEEDOMETER
E DAT$ FROM TO READING + AUTO MILEAGE
20 I�ul POINT POINT START FINISH NATURE OF BUSINESS TRAVELED LED LES ®�b s
PER MILE
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AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed,mileage or official highway map, v
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing aceount.is just and correct,that the amount claimed is legally due,after o ing t credits,
and that no art off the same h s been paid.
Date
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f {7 - MAY 2 1 2014
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BY:
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL['ORM 110.101[logo]
MILEAGE CLAIM �e�n - QY1(1moY1S '
CGp, TO
,(GOVERNMENTAL WIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD.DEPARTI'Ma OR lNSMYTION)
{ SPEEDOMETER
2DAT$ FROM TO READING Wy 9 p 9 4
Q�- NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED - PEA MILE
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AUTO LICENSE NO. TOTALS a 1 O
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account-is just and correct,that-the amount claimed is legally due,after allowing-all jus redits
and that no part of thesame has been paid,
Date 5 ILD 4
rA
MAY 21 2014
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.
358411 Hammons, Jennifer Terms
634 Northview Ave Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note:attached invoice(s) or bill(s)) PO# Amount
5/16/14 Reimb. Mileage 1/13 -4/30/14 $ 329.28
Mileage 11/11 -12/27/13
Total $ 329.28
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
_120—
Clerk-Treasurer
t
Voucher No. Warrant No. I'
I ,
358411 Hammons, Jennifer ` Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of$
$ 329.28
ON ACCOUNT OF APPROPRIATION FOR
1
108 -ESE
�
Dept Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
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1081-10 Reimb. 4343000 $ 329.28 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
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i
22-May 2014
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0
Signature
$ 329.28 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund