244497 04/21/15 CITY OF CARMEL, INDIANA VENDOR: 120950
.;; z;• ONE CIVIC SQUARE DOUGLAS HANEY
CHECK AMOUNT: $"'""*28.55'
i' CARMEL, INDIANA 46032 C/O DEPT OF LAW CHECK NUMBER: 244497
C10 DEPT OF LAW CHECK DATE:. 04/21/15
t ETON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343002 9.00 EXTERNAL TRAINING TRA
1180 4343004 19.55 TRAVEL PER DIEMS
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Prescribed by State Board of Accounts General Form No.101(1955)
MILEAGE CLAIM 4
City of Carmel, Indiana TO �Qi)(ILS 2 DR.
(Governmental Unit)
Department of Law - 1180 On Account of Appropriation No. 434-3004 for Mileage.
Office,Board,Department or Institution
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DATE FROM TO ODOMETERiREADING* NATURE OF BUSINESS AUTO MILES MILEAGE @ 57.S
20 Point Point Start Finish 1. TRAVELED PER MILE
MFIR 41) s Zn c S fid Lo nK e . 3
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Auto License No. TOTALS I Ci 1—�j
*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,Ch pter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,�after
allowing all just credits, and that no part of the same has been paid.
L:
Date
Clcdm No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
OSS C. 4C,n zq
That it is duly authenticated as required
by law;
4 That it is based upon statutory authority;
That it is apparently J correct
$ 1 incorrect
On Account of Appropriation No.4343004 for
Disbursing Officer
Department of Law - 1180
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
CITY OF CARMEL
An invoice or 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
Douglas Haney
Purchase Order No.
1 Civic Square
Terms
Carmel, Indiana 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4/17/15 Pnrki q for IACT conference 4/17/15 $9.00
per the attached
Total
$9.00
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20-
Clerk-Treasurer
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
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Douglas Haney IN SUM OF $
1 Civic Square
Carmel, Indiana 46032
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$ $9.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
434-3002 Ext. Training & Travel
Board Members
PO#or
DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s),
1180 4343002 $O.00 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
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Si nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund