HomeMy WebLinkAbout238115 10/15/2014 vY �� CITY OF CARMEL, INDIANA VENDOR: 120950
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,• ONE CIVIC SQUARE DOUGLAS HANEY CHECK AMOUNT: $""****"121.66*
CARMEL, INDIANA 46032 C/O DEPT OF LAW CHECK NUMBER: 238115
''ltoi!"�°,r: C/O DEPT OF LAW CHECK DATE: 10/15/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343002 17.50 EXTERNAL TRAINING TRA
1180 4343004 104.16 TRAVEL PER DIEMS
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1966)
MILEAOk, CLAIM
TO- noua� as
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. M"3b FOR ('G VP l Per IJ l Q BVI
-� (OFFICE,BOARD,DEPARTMENT OR INSTITUTIOhJ
DATEI FROM TO SPR EDIOMET+
q R AUTO MIL AGE
a?I NATURE OF BUSINESS MILES @ 000 s
1 POINT POINT START FINISH TRAVELED PER MILE
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`AUTO LICENSE NO. TOTALS
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¢ 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 just credits ,
-and that no part of
the same has been paid. Ii
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Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
L n That it is duly authenticated as required
by law .
That it is based upon statutory authority.
That it is apparently correct
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A.E.BOYCE CO.,INC.MUNCIE,IN 01M �• Q+
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Capital Center Garage
251 N. Illinois St.
Indianapol.is, IN 46204-
Fee
6204Fee Computer Number.- `t` - ` .T 1
Cashier: Neil ID #2
Transaction-Number: _— — – - 31
;,'Entered: 09/19/14- 08:51
:Exited: 09/19/14 17:15
;;Ticket #73534 Dispenser #2
Rate: Area 1
Total Fee: $16.00
'Cash: •$ 6.00
Thank you for choosing
Capital Center Garage
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Have a nice day
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STATE OF INDIANA )
SS:
COUNTY OF HAMILTON )
AFFIDAVIT
I, Douglas C. Haney, being first duly sworn upon my oath, state that while I was on City business
attending IACT Legislative Committee meeting in Indianapolis, Indiana, July 22, 2014, I expended $1.10
of my own money for parking at meter#3424 on Capitol Street and for which I need to be reimbursed.
Dated this 1(Z day of October, 2014.
zaney
Subscribed and sworn to before me, the undersigned Notary Public, this L day of October,
2014.
AMANDA BENNETT
- _- NOTARY PUBLIC,SEAQ -- - --
STATE OF INDIANA
RESIDENT OF MARION COUNTY 44
COMMISSION-NO.599586
MY COMMISSION EXPIRES:1-5-2017 Amanda Bennett, NOTARY PUBLIC
Resident of Marion County, Indiana
My Commission Expires:
January 5/2017
[eb:m"vrd:v:�sbared%atfidavits%b=ey aRadivit1widng.dw.10/9/141
STATE OF INDIANA )
SS:
COUNTY OF HAMILTON )
AFFIDAVIT
I, Douglas C. Haney, being first duly sworn upon my oath, state that while I was on City business
attending and speaking at the Hamilton County Leadership Academy in Noblesville, Indiana, September
18, 2014,1 expended$0.40 of my own money for metered parking and for which I need to be reimbursed.
Dated this Q day of October, 2014.
Douglas y
Subscribed and sworn to before me, the undersigned Notary Public, this day of October,
2014.
AMANDA BENNETT
NOTARY PUBUC,SEAL
SLATE OF INDIANA
RESIDENT OF MARION COUNTY
- -COMMISSION NO,599586
MY COMMISSION EXPIRES:1-5.2017 Amanda Bennett, NOTARY PUBLIC
Resident of Marion County, Indiana
My Commission Expires:
January 5/2017
[eb:mnmrd:r.�shared%affidavitsVtaney affadivitimrkingAm.1019/141
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or 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
Douglas C. Haney
Purchase Order No.
Terms
Carmel, Indiana 46033 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/29/14 43002 Parking per-aftached affidavit A I-i 0
-9118%14 43002 Parking per attached affidavit -
9/19/14 43002 Parking per attached receipt $16.00
x
Total
v Jryrr',
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
2
0
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Dou9laTG. HaR8Y IN SUM OF
Carmel, Indiana 46033
$ $17.50
ON ACCOUNT OF APPROPRIATION FOR
Department of Law - 1180
430-43002 External Training Travel
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 43002 $1.101 or bill(s) is (are) true and correct and that
1180 43002 0.40 , the materials or services itemized thereon
1180 43002 16.00 for which charge is made were ordered and
received except
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()C+c�ne r ID 201
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Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund