238673 10/28/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 368106
CHECK AMOUNT: $*********3.92*
ONE CIVIC SQUARE JACKIE REDMONDCARMEL, INDIANA 46032 CHECK NUMBER: 238673
CHECK DATE: 10/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 3.92 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENE
RAL FORD NO.101(1006)
MILEAGE CLAIMTO.
( ERN)4ENSAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OB INSTITRTION)
DAT FROM TO SPEEDOMETER�a AUTO MILEAGE READING + NATURE OF BUSINESS MILES @ p� 0
POINT
POINT START FINISH S�
TRAVELED PER MILE
W I
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AUTO LICENSE NO. TOTALS -3119Z
+ 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,afte allow g all just credits;
end that no part of the same has been paid. —
Date
OCT 212014
BY:
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.
368106 Redmond, Jackie Terms
209 Surrey Hill Ct
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/16/14 Reimb Mileage 9/11/14 $ 3.92
Total $ 3.92
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
, 20
Clerk-Treasurer
Voucher No. Warrant No.
i
368106 Redmond, Jackie Allowed 20
209 Surrey Hill Ct
Carmel, IN 46032
In Sum of$
$ 3.92
�II
I
ON ACCOUNT OF APPROPRIATION FOR l
108 -ESE
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PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-4 Reimb 4343000 $ 3.92 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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23-Oct 2014
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Signature
$ 3.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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