240784 01/07/15 << : CITY OF CARMEL, INDIANA VENDOR: 359461
ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $ ...."131.42"
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK NUMBER: 240784
INDIANAPOLIS IN 46208 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 131.42 TRAVEL FEES & EXPENSE
7vg -
W.
TVC2 92014
. -�"'- GENERAL FORu 110.101 P99s)
PaPSCR1Rro BY vA7E BOARD OF AccouNis
L MILEAGE CLAIM Travel Per Diem
_8 1-1 1-,434004
Extended School Lnrict Iment TO f
!aO ilINr1ENFA••^•^ ON ACCOUNT OF APPROPRIATION NO. FOR NiLeeslla Pittman
Carmel Clay Par's and }Zecreation
(OF.,.-c,eOARD,DE1AATfQ](r OA lNs'[TTUIlON) "
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING + t
POINT t? INT START FINISH NATURE OF BUSINESS TRAVELED ® PERQ•fit^
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CG > OUN S
AUTO LICENSE NO- TOTALS
+ SPEEDOMETER READING columns are to be us6d only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisio sand penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct• that amount claims 1 al y'ti a,after allowing all just credits
and that o a oft am has bean paid. {
Dale
f
V
DEC 29 2014
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.101(1986) :
MILEAGE CLAIM Travel r lem—B-I_1 1=13`x'300+
E_xtencled 5ckool Fnrickment TO -�
n0 ERNYENTA�"��" ON ACCOUNT OF APPROPRIATION NO. FOR 1 •�kees�la Pittman
,Carmel Clay Pars and Recreation
BOARD,DEPARTf@fT OR INSITTMIONj
't'g FROM TO SPEEDOMETER AUTO MILEAGE
D Al�- READING + MILES ® Q,q; t
NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALSjk
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map*fs—ke4ally
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 claime,after allowing all just credits
and that of th same s been paid,
Date
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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/26/14 Reimb Mileage 7/9- 12/23/14 $ 131.42
Total $ 131.42
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
i
Voucher No. ____ Warrant No. —
Allowed 20
359461 Pittman, Nikeesha
2713 Highland Place
Indianapolis, IN 46208 In Sumo $
$ 131.42
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
Dept#.
4343000 $ 131.42 I hereby certify that the attached invoices , or
1081-11 Reimb
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
January 2, 2015
Signature
$ 131.42 Accounts Payable Coordinator
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund