HomeMy WebLinkAbout323687 04/06/18 J' ti• CITY OF CARMEL, INDIANA VENDOR: 366239
s ONE CIVIC SQUARE MONICA HADDOCK CHECK AMOUNT: $*****""162.47*
r ,4 CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 323687
'M„TONS CHECK DATE: 04/06/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 162.47 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 366239 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Haddock, Monica Payee
7546 Ivywood Circle
Indianapolis, IN 46250 In Sum of$ Purchase Order#
366239 Haddock, Monica Terms
$ 162.47 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 $ 162.47 Board Members 3/29/18 Reimb Mileage 1/5-3/29/18 $ 162.47
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
$ 162.47 Total $ 162.47
April 4,2018
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 'PAChim"WU
claim paid motor vehicle highway fund Signature -,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
I
GENERAL FORM 110.181(1986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
PWI l�i h K-tL1�� ro �l
irk r GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEEARTbCWT OR 1Nsrmrr10N1
FROM SPEEDOMETER AUTO TdILEAGE
DAT TO READING MILES
POINT NATURE OF BUSINESS TRAVELED
JL
POINT START FINISH PEA MILE
VT
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+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway.map. 8
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 allowing all just credits,
end that no.par�t�fthe same has been paid.
Date �1�` i H ? +RSC c
ell, kP250
APR 0 3 2010
-BY