319663 12/15/17 CITY OF CARMEL, INDIANA VENDOR: 368930
d t1 ONE CIVIC SQUARE JON OBERLANDER CHECK AMOUNT: $********65.25*
CARMEL, INDIANA 46032 11435 CHARLESTON PARKWAY CHECK NUMBER: 319663
FISHERS IN 46038 CHECK DATE: 12/15/17
DEPARTMENT ACCOUNT PO NUMBER _ INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343004 REIMB 65.25 TRAVEL PER DIEMS
VOUCHER NO. WARRANT NO. Prescribed by state Hoard of Accounts City Form No.201(Rev.1995)
Vendor# 368930 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JON OBERLANDER IN SUM OF$ CITY OF CARMEL
11435 CHARLESTON PARKWAY 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.
FISHERS, IN 46038
Payee
$65.25
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Department of Law Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
Parking 43-430.04 $8.00 1 hereby certify that the attached invoice(s),or 12/8/17 Parking $8.00
1180 101 1180 101
Mileage 43-430.04 $57.25 bill(s)is(are)true and correct and that the 12/12/17 Mileage $57.25
1180 101 materials or services itemized thereon for 1180 1 101
which charge is made were ordered and
received except
Tuesday, December 12,2017
o f\ �v0 nS&
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
J20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM.
TO. IJC 1CZn�P�
City of Carmel, Indiana
(GOVERNMENTAL UNITY
ON ACCOUNT OF APPROPRIATION NO. 434-3004 FOR Mileage
Department of Law - 1180
(OFFICE,BOARD,DEPARTMENT OR INSTITUTION)
DATE FROM TO SPPEIEEDDOOM TREING +R At
f-� NATURE OF BUSINESS MI
20_L_(L POINT POINT START FINISH TRAI
l o - c C D 5 Is c
$ eA ( Sk t+ —% 6 -l o3— 3-bllozl
AUTO LICENSE NO. TOTALS / O
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fined 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 allowing
end that no part of the same has been paid..
Date
DENISON PARKING 7140
301 E WASNINGTONSTREET
INDIANAPOLIS, IK 46204
(317) 916-1760
THANK YOU
Bank ID: 1340
Merchant ID: 000022660209
Term ID: 002
Sale
XXXXXXXXXXXX7317
NASTERCARD Entry Method; Chip
Total: $ 8,00
12/08/17 09:09:54
Inv 0: 000030 APpr Code:: 008576
Wrvd: Online Bat.00 342001
Retrieval Ref.il: 40109023
Debit MasterCard
AID: A0000000041010
TSI: 6800
TVR: 0000008000
Custom ..uDY