322445 03/05/18 CITY OF CARMEL, INDIANA VENDOR: 372278 *
ONE CIVIC SQUARE ANTHONY FLETCHER CHECK AMOUNT: $ w 40.68
=Q . CARMEL, INDIANA 46032 3817 COOPER SQUARE CT CHECK NUMBER: 322445
9 ,.. APT 11202' ' CHECK DATE`. 03/05/18
INDIANAPOLIS IN 46205
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 40.68 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# -39�^�e Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Fletcher,Anthony p( Payee
3817 Cooper Square Ct,Apt 11202
Indianapolis, IN 46205 In Sum of$ Purchase Order#
Fletcher,Anthony Terms
$ 40.68 3817 Cooper Square Ct,Apt 11202 Date Due
Indianapolis, IN 46205
ON ACCOUNT OF APPROPRIATION FOR
108-ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-2 Reimb 4343000 $ 40.68 Board Members 2/15/18 Reimb Mileage 10/2/17-1/24/18 $ 40.68
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
$ 40.68 Total $ 40.68
February 26,2018
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 1pkhuftLh�
claim paid motor vehicle highway fund Signature —.20_
Accounts Payable Coordinator Clerk-Treasurer
Title
,C R,X D
FEB 222018
BY:
.. •••••••••••••••••••••••••••••• GD7EAAL FORM 110.to]11906)
PRIESCRIBED BY STATr BOARD OF ACCOUN73
MILEAGE CLAIM
C C--? (2,
71
l(3o= ON ACCOUNT OF APPROPRIATION NO. FOR
(OF,-ICL',BOARD.121 ARTWINT OR)116171 r10N)
SPEEDOMETER AUTO 21ILEAGE
DATE, FROM TO READING I NATURE OF BUSINESS MILES a f
D POINT POINT START FINISH TRAVELED PER MILE
Yh LC f i35- 3,75
` AA L(- 3.7.5
CC_
I
AUTO LICENSE NO. TOTALS
+ 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 155,Acts 1953,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after all q all just credits
2nd that no pa Of lhq rsame has been paid. _
Date Z��5 ( ( 6
3°0`� 2D2 , 4�zos