HomeMy WebLinkAbout321335 01/30/18 �y. ''• CITY OF CARMEL, INDIANA VENDOR: 366239
°I ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: $*******143.45*
9, ,? CARMEL, INDIANA 46032 C/O ESE CHECK CHECK NUMBER: 3011 33508
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 143.45 TRAVEL FEES & EXPENSE
4
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 366239 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Haddock, Monica Payee
7546 Ivywood Circle
Indianapolis, IN 46250 In Sum of$ Purchase Order#
366239 Haddock, Monica Terms
$ 143.45 7546 Ivywood Circle Date Due
Indianapolis, IN 46250
ON ACCOUNT OF APPROPRIATION FOR
108-ESE
PO#or Invoice Description
Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-2 Reimb 4343000 $ 143.45 Board Members 12/26/17 Reimb Mileage 10/10-12/26/17 $ 143.45
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
$ 143.45 Total $ 143.45
January 23,2018
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
1 '
GENERAL FORId Ito.10)11906)
PRESCRIBED BY STATE HOARD OF ACCOUNTS
MILEAGE C! AIM
(GovERN ENIAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
IOE7ICE, n D,DEPAATI[LTfi OR 1NSTmn10N
_ SPEEDOMETER AUTO AGE
DA FROM TO RF1i01NG + MIL£S a
_ NATURE OF BUSINESS TRAVELED
POINT POINTSTART I FINISH PER,MILE
10
!-
CT
M02-
J.
I �
Y I
. , V I• j
�^
L Cr
—s� c C
2k 0 C-
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns Fare 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 155,Acts 1953,I hereby certify that the foregoing�acount is just and correct,that the amount claimed is legally due,after allowing all just credits
?nd that no cpart
-ofr thee�same has been paid.
Date
FJ
2 2018
I
1 I