246328 06/17/15 ,G�q
CITY OF CARMEL, INDIANA VENDOR: 366239
ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: $*******117.30-
a° CARMEL, INDIANA 46032 C/0 ESE CHECK NUMBER: 246328
•'''�*6N�°. CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 I2322151 117.30 TRAVEL FEES & EXPENSE
1
JUN - 5 2015
`J.
PRCSCRIHCD BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1986)
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---=-=—==MILEAGE CLAIM o
(ogxrnNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFtICE,BOARD,D))EPARTLENr OR INSTRUTION)
FROM TO SPEEDOMETER AUTO UMEAG£
M
DAT READING + MILES
.20POINT
O POINT START FINISH NATURE OF BUSINE56 TRAVELED11 1 7-r PER
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AUTO LICENSE NO. 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 claimed is legally due,after aliowing all just credits /
and that no. ajrtt of
the same has been paid.
Date ��
_q�q2vD
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.
366239 Haddock, Monica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
6/3/15 Reimb Mileage 4/16 - 5/28/15 $ 117.40
Total $ 117.40
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.
366239 Haddock, Monica Allowed 20
In Sum of$
$ -4+7-40
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Board Members
PO#oEINVOICE NO. CCT#/TITL AMO(fT D,b
Dept#
1082- imb 4343000 $ 44449— 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
June 11, 2015
Signature
$ 117.40 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund