241235 01/22/15 o
CITY OF CARMEL, INDIANA VENDOR: 360144
ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: S*******122.52*CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK NUMBER: 241235
NOBLESVILLE IN 46060 CHECK DATE: 01/22/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIM 122.52 TRAVEL FEES & EXPENSE
rUZCF18ED DT STATC HOARD OF ACCOUNTS GIXFKAL FOXW Fr; 101 IME1
MILEAGF, CLAIM
ON ACCOUNT OF APPROPRIATION NO. FOR
FRO?.i TO 1 AUTO GE
DATE
1READING 4----- NATURE OF BUSINESS MILES PER WLE
FORT 'IT START FINISH TRAVELED
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TOTALS
AUTO LICENSE 110,
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determineii by liXE!Cl mileage Or Official highway Map,
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing az;r-ount is fust and--orrecl,that the amount claimed is legally due,-AIPT aliOlving all Inst credit-
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end that pn�t Of the same has been paid
Date
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JAN 14 2015
BY:
PRtSCPtlED DT STATE SOARD OF ACCOUNTS Ct NrBAL FORM Nr 101 t19RF!
MILEAt3E CLAIM
TO...
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t rxHstENrAEuxtrt ON ACCOUNT OF APPROPRIATION NO. .� FOR
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DATE 1 --.._- -_
FROM TOSREADING TFA Ate$ GE C
-.---_r-._.-...._.----------•-•- NATURE OF BUSINESS gRAVELF,
POINT PONTS',ART FINISH PER 1lIL&
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AUTO LICENSE 40. TOTALS !
t SPEEDOMETER READING aolumns 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 ceTtity that the foregoing account is just and correct,that the amount claimed is legally due,alter aliowing all Mist credits
end that no p it of the same has been paid /.
Date
JAN 14 2015
PAMCMED DT STATC HOA xD Or ACCOUNTS C KERAL JONM Vr,; IN IME
MILEAGE CLAIM �
(WYEARKENTAL VNEn ' - - ON ACCOUNT OF APPROPRIATION NO. FOR —_ —
(bJ710E,iOARD RETAATWWa OR WSCIrlRiONj�'— -.
nAT9 —� FROMTOSREADINGT+A } AUTO P QGE c
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— F07E77 POINT S:AAT FINISH PER E6i
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AUTO LICENSE 40. — --TOTALS Li
-._—_
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Puirmant to the provisions and penalties of Chapter 155,Acts 4953,I hereby certify that the foTegoing account is Iust and correCf.that the amount claimed is legally due,after abotiving all Inst credits.
end than no pa t o1 the same has been paid.
Date 1 �
04
oq
JAN 14 2015
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/5/15 Reimb Mileage 10/14- 12/26/14 $ 122.52
Total $ 122.52
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of$
$ 122.52
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-5 Reimb 4343000 $ 122.52 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
January 15, 2015
Signature
$ 122.52 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund