249670 09/23/15 ��ir LAA.�rf
�; � - CITY OF CARMEL, INDIANA VENDOR: 369160
® it ONE CIVIC SQUARE MAX ELLIS CHECK AMOUNT: $ ......18 18.07-
CARMEL,?� CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 249670
'a/,ro�';-0� CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 18.07 TRAVEL FEES & EXPENSE
i SEP s. 0 215
I.--_—_-_ -- 6F.ltFAAL roAu ec iet ureal
pmevneto Br StA-BOA"Of ACCOUNTS MILEAGE CLAIM
TO-._._L°
- ON ACCOUNT OF APPROPRIATION NO. �
FOR
( VIRNMLNLAL IIIitn
7} XOB S _ PEE�OMA
WARD.DVANESS M @
FROM TO READING + NATURE OF BUSIRAVELM
� t
-?ER ME
DATE POINT START FINISH
QO POINT _ f _ $ P 'r- 72T
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C W Sw^^A r c4 6
12 ML �( --- b AeL ffUA1 PAP,' 'ta s f 14
-
e�
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---- TOTALS
AUTO LICENSE NO. __ — ----
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by laxed mileage or al highway map.
Pursuant to the provisions and penahles o!Chapter 155,Acts 2953,I hereby cattily that the lorecgoinq account is just and correct,that
lhat nt tthe amount claimed is legally duIt
e,, tvinq all Iust credits,'
end that n�o•� the same has been paid.
Date 2>✓L part of —T
/fir
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.
369160 Ellis, Max Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/28/15 Reimb Mileage 4/15- 8/5/15 $ 18.07
Total $ 18.07
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. ,� ''
369160 Ellis, Max Allowed 20 -'
�a
In Sum of$
$ 18.07 Y
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept# � :
1082-12 Reimb 4343000 $ 18.07 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
September 17, 2015
Y ' Adt&��
S°. •. .
Signature ,.
$ 18.07 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
sa '