251163 11/04/15 o�;� "°� CITY OF CARMEL, INDIANA VENDOR: 369939
V.
;; b ONE CIVIC SQUARE JENNIFER LANE CHECK AMOUNT: $**......18.00*
CARMEL, INDIANA 46032 6912 HARRIET DRIVE CHECK NUMBER: 251 163
+y,_oN�, INDPLS IN 46237 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4358200 REIMB 18.00 SPECIAL INVESTIGATION
OF
TQ,FTVtI(sp( \
i, CITY OF CARMEL Expense Report (required for all travel expenses)
\NDIANP-'/
EMPLOYEE NAME: Jennifer Lane DEPARTURE DATE: TIME: AM / PM
DEPARTMENT: Carmel PD RETURN DATE: TIME: AM / PM
REASON FOR TRAVEL: Court DESTINATION CITY: Indianapolis-Court Appearance-Parking
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
10/1/15 $6.00 $6.00
10/5/15 $6.00 $6.00
10/20/15 $6.00 $6.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
0.00
Total $0.00 $0.00 $0.00 $18.00 $ $0.00 $0.00 $0.00'___ $0.00 $0.00 $0.00 01
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form#ER06 Revision Date 10/27/2015 Page 1
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
10/30/15 parki ng582 $18.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jennifer Lane
IN SUM OF $
6912 Harriet Drive
Indianapolis, IN 46237
$18.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 43-582.00 $18.00 I 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
Thursday, O ober 29, 2015
41Z Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund