HomeMy WebLinkAbout324361 04/25/18 CITY OF CARMEL, INDIANA VENDOR: 362873
is ® ONE CIVIC SQUARE ADAM WILLIAMS CHECK AMOUNT: $*******"14.71
f ?Q CARMEL, INDIANA 46032 8255 CHRISTIANA LANE CHECK NUMBER: 324361
gy�rON�o` INDIANAPOLIS IN 46256 CHECK DATE: 04/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 14.71 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 362873 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Williams,Adam Payee
12461 Autumn Gateway
Carmel, IN 46033 In Sum of$ Purchase Order#
362873 Williams,Adam Terms
$ 14.71 12461 Autumn Gateway Date Due
Carmel, IN 46033
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or Invoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-3 Reimb 4343000 $ 14.71 Board Members 4/11/18 Reimb Mileage 3/22-4/9/18 $ 14.71
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
$ 14.71 Total $ 14.71
April 17,2018
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
o- GENERAL FORL No.101(1ges)
PRESCRIBED BY STATE BOARD OF ACCOUNTS _
r � MILEAGE CLAIM
i7To
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR INsmunoN)
SPEEDOMETER AUTO MI AG
DATE FROM TO READING + MILES Q
NATURE OF BUSINESS TRAVELED
21}- POINT POINT START FINISH PER MI
a��r w �•s� e 1 O ' --
�
AUTO LICENSE NO.
TOTALS 1 i
+ 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 alto ving all just credit:
and that_no-part-of=the-same_has,been paid. ?
Dat
r AR 16 2010
I EY.