HomeMy WebLinkAbout243721 03/31/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 358411
ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $*******465.57*
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK NUMBER: 243721
INDIANAPOLIS IN 46220 CHECK DATE: 03/31/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 465.57 TRAVEL FEES & EXPENSE
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57.
Mid' MAR 19 5
PRESCRIBED 8Y STATE HOARD OF ACCOUNT' y �� GENERAL FOAM 110.101(1986)
-� MILEAGE CLAIM
CTO ,^ ^ 1
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(eOVEANM NTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
[OFi'iCE,HOARD,DEPARTMENT OA IN 108)
DATE FROM TO SPEEDOMETER
READING .i. N1VTEOLW
MILEAGE
2�L� POINT POINT START FINISH NATURE OF BUSINESS TRAVELED , 5"15 C
PER MILE
o O to
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101
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AUTO LICENSE NO. TOTALS Ll 1 -5
+ 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 due,after allowing all just s,
and that no part of the same'has been paid. L y
Date
1 I
l
Carmel • Clay
�i Parks&Recreation , {? /O
Employee Expense Reimbursement Request 463ce CDoreare
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Descriptiop Amount. Purpose of Expense
�aiM• Rv a 4r� Q�r I �_1 ��3���bbC� oe'fl 1�� I In . -10
.� `14• is: cocoo` Pj�orn 000�j +�11•
C d'I S� �c i 11 C. l<6�n c� . C�6 G� I ILA• c Ci C<J-O re vtcl� -rl`ec.�i
J ('G ISS Coe oma, �10e.n I .2
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• CI l�c�UneS �i 2T � oUS2_ �C?U�
All receipts should be attached in the same order as listed above. , `
No sales tax will be reimbursed. TOTAL: $ ! 5-q/ I
Ofd
Employeee•Name(print) ��� GY`f�MI�Y1S p�'
Address l9
Check p ,
payable to: City, St,Zip I lfl �ir1c.I�U�iS �� i �4 o� o
F/Y
Signature: Approved by:
Date: CQ Date. I J
Revised 3-2-07 by Business Services; r,-
Shared/Forr
Shared/Forms and Templates/Business Service Fos/Employee Exp Reimb Request 2007-3 MAR 2 ® 2015
BY
•
Carmel • Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account �Q
Receipt Vendor listed on receipt # Line# Budget Description I Amount Purpose of Expense
- IS 'g' 15 '�IG�io�� ��C�tY'Q� Gc, cna 'CI � Foo � `VQ.� � �c J C�,n�reY, Yrej
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� • l 0 l� �i 0 r'e��a Z2�1 �oo� £�Cb�`�' � , K C�cY e-nce tv��
I lS IZxi cc no
CosoG ` A c�,1\ mks&- cOV� �' I `0 C tV�C iY�
All receipts should be attached in the same order as listed above. l
No sales tax will be reimbursed. TOTAL: $ ,
Employee4 Name(print)
Address (9 si n o c*V�en.J
Check
payable to: City, St,Zip va-k c,,Va�0\, S
Signature: J� Approved by:
a
Date: I ta /is Date: 9) I V/
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3 MAR 2 0 2015
BY:
s'r
enn
i
Hammons
on
Carmel Clay Parks & Recreation
?f Carmel, IN
United States
AfferSchool
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.a
,
National Afterschool
Association Convention 0
The Afterschool for All Challenge
o'C,
rassiona
P : O t
.4
t
AfterSchool - • •
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
3/16/15 Reimb. Mileage 1/20- 3/13/15 $ 206.43
3/16/15 Reimb. Travel expenses for NAA Conference $ 259.14
Total Is 465.57
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$
$ 465.57
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
f
PO#or INVOICE NO. ACCT#/TITLE AMOUNT l Board Members
Dept#
1081-10 Reimb. 4343000 $ 206.43 I hereby certify that the attached invoice(s), or
1081-99 Reimb. 4343000 $ 259.14 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
I ;
i.
March 25, 2015
11
'P
Signature
$ 465.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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