HomeMy WebLinkAbout239977 12/09/14 �u!.kngy
v`! CITY OF CARMEL, INDIANA VENDOR: 366663
® ONE CIVIC SQUARE AMANDA GILLIM CHECK AMOUNT: $*******142.98*
9� ��; CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 239977
*,TON�' CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 142.98 TRAVEL FEES & EXPENSE
OW"ILEa DY STATE ZOAAa OF ACCOUM CEMFOAL FORM UG IN t198E1
MILEAGE CLAIM
t rxn>rEtlrALlulm —" - ON ACCOUNT OF APPROPRIATION NO. FOR
)0F710E,110AAa.PEr"Maw 08 INSrmnlo11) ---`
n&�T-v FROM To R 'D AUTO
1- POINT -� POINT — START FINISH NATURE OF BUSUiESS �AM��Q �� �
PER MILE
- - M
rz__ M _--. _ —_y �•
KALL, I — t 71
—
fr4 IMOD'
----tJ--• 11>1 K
-
- W �t__..
LA
93,Lf
ANT
i ------- � - -
Z3 AUTO LICENSE:i0. I J •._-_. t 4:17(
- —J TOTALS ' -1 53 1) \I
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by laxed mileage or official high w P.
Parsaant to the provisions and penalties of Chapter 155,Acts 1953,I herebY aeTtify that the inTPgoing account i3 just and Correct,that ih mount claim is 11 due,after al' ving a credits
and that n ar of the same h4s been paid.
Date
\U DEC -- 2 2014 ,�►��.
C:
BY: ��
CNSLRILCD BY SrAIt nOAxII Of ACCOUNTS � GrxrB)11 iOxM up 1PI{l9FE)
MILEAGE CLAiM
TQ_._..._._
t nINNENrA[uNm - ON ACCOUNT OF APPROPRIAIION NO. FOR
—" toract.BOARD.ID"Xxrb- Ox WStmalos)
1tIIT0 E
�A�TyE� FROM — ~— READING } NATURE OF BUSINhSs MILES G WE c
POINT POINT START FINISH TRAVELED; PER MIIY
—
_--i -
AAQAof
ff - —
Lf
10
Gv I
--
0 2 AA r L
0 2 � _. __ J3— _ —— • L — t
to
AUTOMCENSENO. 01 1
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to lice provisions and penalties of Chapter 155,Acts 1953,I hereby COTtily that the foregoing account i+just and correct.that ttb¢am nt clar ed is legally due,after alio g all redits.•
end that no par of the e has s en paid.
\�Date
AC 1
DEC -.2 2014
MSCPIBED BY STATE BOARD Of ACCOUWM . GEWSAL FOAM PO l(':VWQ
MILEAGE CLAIM Y -
T raNrlEnrAaiBiiTt ON ACCOUNT OF APPROPRIATION NO. FOR
-- torwicr.somm.OttA Iw"on uistrnmom) -----
•-ir AUTO MILEAGE FROM V TO — READING } I NATURE OF ES
RE S�
FOINT —� POINT SART FW1SH TRAVELED
PER MILE
kAC C_
J &rT
-- c --- - —
�� - kke,2 `'
FM jAaA
MICA—
�1L _ 1-
c <� —
FEE
AUTO LICENSE NO. � -- TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be delerminod by fixed mileage or official highway map.
Pursuant to Use provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is jus]and correct.Thal the am L e is legally due,after a st redit
end that no part f the ame s been paid.
Date
�r�D
-- DEC -2 2t)14
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.
366663 Gillim, Amanda Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/1/14 Reimb Mileage_8/5- 12/1/14 $ 142.98
Total $ 142.98
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.
366663 Gillim, Amanda Allowed 20
In Sum of$
$ 142.98
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#orBoard Members
Dept#
INVOICE NO. CCT#1TITLE AMOUNT
1081-5 Reimb 4343000 $ 142.98 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
3-Dec 2014
Signature
$ 142.98' Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund