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HomeMy WebLinkAbout320217 01/04/2018 CITY OF CARMEL, INDIANA VENDOR: 368929 CHECK AMOUNT: $********53.79* ONE CIVIC SQUARE LESLIE WIMBERLY ?� CARMEL, INDIANA 46032 C/O PARKS DEPT CHECK NUMBER: 320217 M` CHECK DATE: 01/04118" DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION_ 1081 4343000 REIMB 53.79 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER' CITY.OF.CARMEL VOUCHER NO.. WARRANT NO. . . - An invoice of bill to be properly itemized must show;kind.of service,where performed,dates service rendered,by Vendor# 368929 Allowed 20 . whom,rates'per'day;number of hours,rate per'hour,number of units,price per unit;etc: ' Wimberly; Le§lie Payee 10832 Club,Circle Indianapolis; IN 46229: In Sum of$ 368929. Purchase Order.# . . : Wimberly,Leslie: Terms 53.79 10832 Club Circle; Pate Due Indianapolis,'.IN 46229 ON ACCOUNT OF-APPROPRIATION FOR. 108 ESE. PO#or INVOICE N0. ACCT#!TITLE AMOUNT Invoice ' Invoice. Description Dept#. Date Number (or note attached invoice(s)or bill(s)) -PO:# Arbourit 1081-8. = Reirtfb 4343000: $ 53.79 Board Memtiees 12/5/17 : Reimb . : :Mileage 9/25-12/5/17 $ 53.79: hereby certify that the attached in'voice(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 $ : .53.79q Total $ : 53.79 December 27,2017 1 hereby,certify.that the attached'invoice(s),or bili(s)is(are)true.and correct and I have audited same in accordance with IC 5-.11-10-1.6 Cost distribution ledger classification,if: claim paid motor vehicle higfiway fund Signature 20 Accounts Payable Coordinator Clerk-Treasurer .Title PRESCRIBED BY STATE HOARD OF ACCOUNTS GENERAL FORM NO.101(1986) MILEAGE CLAIM 5 To---..- % ERNMENTAL UNIT)/'5r� ON ACCOUNT OF APPROPRIATION NO. FO lt (OF-ICE,BOARD,DEPARTMENT OR INSTITUTION) SPEEDOMETER ATE FROM TO READING { ILEAP NATURE OF BUSINESS MILES p UTO M� POINT POINT START FINISH TRAVELED PER MILE 2SAVP 8 1't U6 2 M n 2 8 0 U Mhzw of Ac a✓i3 8 31 &&g&V /SIG 2 Y y e 14 2 rr, 9 r M h t G, i /1 of it 1 a i 2 S LV AM 1 C C- f"I'n5,4 - T17 A4 2 c o 'rAm a ✓ lztr✓ �.Ir2 2 2 S' M CG S _ I AUTO LICENSE NO. TOTALS J ,S + 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 15S,Acts 1953,I :tifv thaLthe_foregoing account is just and correct,that the amount claimed is legally due,after Io ing all ' st credits: and that pari of thame has been paid. Date 1 �S I � ,.�' `�y�'�> . DEC 2., 1 1017 LI/ 9 ...... 1���2 club brc-fG-e.