HomeMy WebLinkAbout304213 10/13/16 04a W C�q�f
CITY OF CARMEL, INDIANA VENDOR: 369557
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ONE CIVIC SQUARE AIMEE RICH CHECK AMOUNT: $********84.29*
:. =a CARMEL, INDIANA 46032 4907 SUNVIEW CIRCLE#1222 CHECK NUMBER: 304213
9.y�TON INDIANAPOLIS IN 46237 CHECK DATE: 10/13/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 100316 84.29 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
Allowed 20
369557 Rich, Aimee
8821 Navigator Dr
Indianapolis, IN 46237 In Sum of$
$ - 84.29
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 84.29 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 7, 2016
L
Signature c
$ 84.29 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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.
Terms
369557 Rich, Aimee
8821 Navigator Dr
Indianapolis, IN 46237
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/3/16 Reimb Mileage 9/6 - 9/29/16 $ 84.29
Total $ 84.29
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
, 20
Clerk-Treasurer
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO.101(INN)
MILEAGE� CLAIM?rQVQ.` �2r 1�1Q,� 1(�c�.t•,(,�0� _�?JU�O�b�e C1�hol stn c'icli(Yfnt 1 V
(GovERNMENTu UN1T) ON ACCOUNT OF APPROPRIATION NO. FOA `` f?-L`
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(OFFICE,DOAK DEPARTMENT'Oki alanTmIuN)
FROM TO SPEEDOMETER
D'A'TES READING + AUTO MILEAGE
20 POINT POINT START FINISH NATURE OF BUSINESS TRAVELS @_ .VD4 0
PER Max
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AUTO LICENSE NO. TOTALS {�_• 1 RLq
+ SPEEDOMETER READING Columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. I
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 le ally due,after aIIow' all fust credits.
end that no part of the same has b-eeend paid.
Date
RIECET
1 OCT 07 2016 i
BY: I
boot 1Javi CO -ems .D�, -T-CtidIP15 'D� 4&,V)-7