242273 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 366663
b ONE CIVIC SQUARE AMANDA GILLIM CHECK AMOUNT: $**.....1 18.48*
a° CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 242273
CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 118.48 TRAVEL FEES & EXPENSE
PRESCRIBED B7 STATE BOARD OF ACCOUNTS . ^ ^G ENRR AL FORK 110.101(1986)
MILEAGE CLAIM4M.Omda
TO
(GOVERNMENTAL UNI'n
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFEICL,BOARD,DEPARTMENT OR INSTMITION)
DAT FROM TO I SREAD NG + AUTO E
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PONT PONT START FINISH NATURE OF BUSINESS TAAYELED
PER MILE
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AUTO LICENSE NO. (1:7 0 TOTALS
+ 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 cla is legal due,after alio
and that no part f the ame has been paid. \
Date _ oaL
2 5 S
FEB -9 2015
' 7 � �
PWCAIEED BT STATE BOARD OF ACCOUNTS GENERA[FORM PO 101 119551
MILEAGE CLAIM
( VEANMENTAL UNIT1
ON ACCOUNT OF APPROPRIATION NO. FOR
-- (OFFICE,BOARD,DEAARTMPrr OR INSTTTUrION) I _-•- - _
SPEEDOMETER
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PER MILE-
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AUTO LICENSE NO. Z .—_--- – -- TOTALS,
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+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highwa
Pursuant to(lie provisions and penalties Of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is fust and correct.that the am nt claimed isle due,after aliow' a lust is
end that ncfpart of fhe same has been paid.
Date —
a)
cr
g
FEB -9 115
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 _T
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
2/9/15 Reimb Mileage 12/2/14 - 1/30/15 $ 118.48
Mileage 8/5-12/1/14
Total I $ 118.48
1 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
Voucher No. Warrant No.
366663 Gillim, Amanda Allowed 20
In Sum of$
$ 118.48
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-5 Reimb 4343000 $ 118.48 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
February 12, 2015
Signature
$ 118.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund