321552 02/13/18 q CITY OF CARMEL, INDIANA VENDOR: 369557
6 3', ONE CIVIC SQUARE AIMEE RICH CHECK AMOUNT: $********63.17*
CARMEL, INDIANA 46032 4907 SUNVIEW CIRCLE#1222 CHECK NUMBER: 321552
INDIANAPOLIS IN 46237 CHECK DATE: 02/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 63.17 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 369557 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Rich,Aimee Payee
211 Junction Pass#213
Westfield, IN 46074 In Sum of$ Purchase Order#
369557 Rich,Aimee Terms
$ 63.17 211 Junction Pass#2G Date Due
Westfield,IN 46074
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
1081-99 Reimb 4343000 $ 63.17 Board Members 2/1/18 Reimb Mileage 1/2-1/31/18 $ 63.17
I 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
$ 63.17 Total $ 63.17
February 7,2018
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
PRESCHWED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAICLAIMGENERAL FoamNO.101(1806)
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fOF?ICE,BOAA/D`,1 OA T ruUnoN)
�DATE FROM To READIING+
ER
-f- AUTO btiT.Yar_e
POINT POINT START FINISH NATURE OF BUSINESS MILES
TRAVELED
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AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined bir fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter AS,Acts 1953,I hereby certify that the foregoing accountis_just_and correct,that the amount claimed is legs due,after allowing all just credits.
and that no part of the same has been paid. i
Date
2• i • l � �
FEB 0 5 2010
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