HomeMy WebLinkAbout321533 02/13/18 v CITY OF CARMEL, INDIANA VENDOR: 358411
d ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $********59.92*
CARMEL, INDIANA 46032 323 NORTHERN AVENUE CHECK NUMBER: 321533
9 INDIANAPOLIS IN 46208 CHECK DATE: 02/13/18
t�TOEI�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 59.92 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 358411 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Hammons,Jennifer Payee
323 Northern Ave
Indianapolis, IN 46208 In Sum of$ Purchase Order#
358411 Hammons,Jennifer Terms
$ 59.92 323 Northern Ave Date Due
Indianapolis,IN 46208
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
1081-10 Reimb 4343000 $ 59.92 Board Members 1/30/18 Reimb Mileage 10/31-12/8/17 $ 59.92
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
$ 59,92 Total $ 59.92
February 7,2018
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
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM 110.101 110867
/'� C MILEAGE CLAIM \ r
V�Jr�� �+� � V �a TO
taovERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
( F110E,BOARD,DEPARTMElff Oe INSTITUTION)
SPEEDOMETER AUTOMILEAG
DATE FROM — TO t1EADINt3 - NATURE'OF BUSINESS
1
` �- POINT POINT START FINISH TRAVELED PER MILE
-- 2
-- -o
Ckov �_. (Y\o nary nuc . 1YZonw, -VVC _
Z Mo•rt� • f:.. _ 2�
Z
e �_ rt\ortiw. •
tc-C1 anovt VN C_ Sco
- til L �(Y`o,��,ri•W C� —.—. S yo
it
- f
t
AUTO LICENSE NO- TOTALS 1 1 Z 5C� et Z-
+
+ 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 Chdpter 155,Acts 1853,I hereby Certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits
and that no pari of the samehasbeen paid.
Date
FEB 052018
W