HomeMy WebLinkAbout251101 11/04/15 ♦i�"AbF
CITY OF CARMEL, INDIANA VENDOR: 366239
ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: 5"''"'"91.43'
,? CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 251101
CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 91.43 TRAVEL FEES & EXPENSE
CE V .i:sD
00 i 19 2015
PRESCRIBED BY STATE BOARD OF ACCOUNTS BY: GENERAL FOAM NQ 101 11986)
MILEAGE CLAIM
TO `t�)� N`
�1
�.J (
3OVERNMENTAL MITI
ON ACCOUNT OF APPROPRIATION NO. FOR
(OfiICP, EPAATID7IT OR INSTITUTION)
D1,TE FROM TO SAEADOMING +M AUTO UIL.EAGE
2a r NATURE OF BUSINE56MISS a cCij,5
7—s1 POINT PORJT START FINISH TRAVELED
1' PER MILE
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5 vet
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1 T —1-40- --- L 3
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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
endthat�n�par6t,hrme has been paid.DateC6
l V
- `
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
10/15/15 Reimb- Mileage 9/22- 10/15/15 $ 91.43
Total $ 91.43
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$
$ 91.43
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Board Members
PO#or INVOICE NO. CCT#/TITL AMOUNT
Dept#
1081-2 Reimb 4343000 $ 91.43 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
October 20, 2015
Signature
$ 91.43 Accounts Payable Coordinator
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund