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241899 02/09/15
CITY OF CARMEL, INDIANA VENDOR: 358411 CHECKAMOUNT: $*******212.80* (9, ONE CIVIC SQUARE JENNIFER HAMMONSCARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK NUMBER: 241899 INDIANAPOLIS IN 46220 CHECK DATE: 02/09/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 212.80 TRAVEL FEES & EXPENSE PRESCRIBED BY STATE BOARD OF ACCOUNTS 1 1 GENERAL FORTS 110.101 VF06) CG{'Q- G S MILEAGE CLAIM (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO_ FOR (OFFICE,BOARD.DEPARTA@fl'OR INSTITUTION) ! DATE FROM TO SPEEDOMETER TER AUTO MIL5A'GE C 4 1 NATURE OF BUSINESS MILES p u (a 4 ' POINT POINT START FINISH TRAVELED - PER MILE "1 M vim, H� � •vac. - w � S wc-• I tip 11ate wc• Ic`r�al art .wit I tD 11 2.0 Zvi � It Q A It 1S Lk 6 IR LA I'kil Z WG C• c�( \N IR I't '-'PJ C. "-\a '0\.\aL\ 20 G 0n To _ \ 2 (2 v.. Pn WCC C.• c I 1 a t ar-orn•WC. SIC- 1• Vie `L . W W11 It,, 11 1 of to 2Z. C: . otic 77_ W(r • -r^ •w� ( T - - . O t � ori -2,0- WC, it 113 q14 ALTO LICENSE NO. TOTALS © a I a OQ + 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 d1 a,after allow�all just c is and that no part of the same has been paid. Date JAN 2.6 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. 358411 Hammons, Jennifer Terms 634 Northview Ave Date Due Indianapolis, IN 46220 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 1/16/15 Reimb. Mileage 10/2/14- 1/14/15 $ 212.80 Total $ 212.80 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 i Voucher No. Warrant No. 358411 Hammons, Jennifer Allowed 20 634 Northview Ave Indianapolis, IN 46220 In Sum of$ I� $ 212.80 i ON ACCOUNT OF APPROPRIATION FOR 1. 108 -ESE i. I _ I Po#or Board Members De t# INVOICE NO. ACCT#ITITL AMOUNT P 1081-10 Reimb. 4343000 $ 212.80 Ihereby 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 i iieceived except � f 1 �(( January 29, 2015 1 Signature I $ 212.80 ; Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I