HomeMy WebLinkAbout305781 12/07/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 366239
ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: $*******150.66*
CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 305781
CHECK DATE: 12/07/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 150.66 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
366239 Haddock, Monica Allowed 20
7546 Ivywood Circle
Indianapolis, IN 46250
In Sum of$
$ 150.66
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. A.CCT#/TITLE AMOUNT Board Members
Dept#
1081-2 Reimb 4343000 $ 150.66 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
November 23, 2016
Signature
$ 150.66 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
GENERAL FORM 110.101(1996)
PRESCRIOED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
TO
��ENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OF.-ICE,BOARD.DE}ARTME"OR INSMIMON)
TE FROM TO SPEEDOMETER AUTO VILE E
DtL + MILES
26 l u POINT START FINISH
FINISH NATURE OF BUSINESS TRAVELED PER
POINT
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B
MrC -7K
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1 &KUTO LICENSE NO_ ��' TOTALS G
14
+ SPWONfM READING c lninns are—-Cie—s*"en istance INCpoints cannot be determined by fixed mileage or official highway map. ;Lf J
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 aliowinq just credi
end that no part of the same has been paid.
Date �`V Q �iUlWQi6� /Il t�,�J
Jl -iv--C(IC is ttan
NOV 2 3 2016