325227 05/15/18 / lj uf_C4A,yf(
CITY OF CARMEL, INDIANA VENDOR: 371641
ONE CIVIC SQUARE KAYLA WILLIAMS CHECK AMOUNT: $********51.49*
CARMEL, INDIANA 46032 5926 APACHE WELLS APT 447 CHECK NUMBER: 325227
INDIANAPOLIS IN 46224 CHECK DATE: 05/15/18
4 ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 51.49 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 371641 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Williams, Kayla Payee
5926 Apache Wells. Apt 447
Indianapolis, IN 46224 In Sum of$ Purchase Order
371641 Williams, Kayla Terms
$ 51.49 5926 Apache Wells. Apt 447 Date Due
Indianapolis, IN 46224
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-5 Reimb 4343000 $ 51.49 Board Members 5/3/18 Reimb Mileage 8/31/17-4/17/18 $ 51.49
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
$ 51.49 Total $ 51.49
May 8,2018
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
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G WAL rOAN Ito ICI ROM
Vpjt9c tlaEo DY STATE HOAxO Or ACCOUNTS
11�� MILEAGE CLAIM WIN '
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teov�x>trNrAl.unm ON ACCOUNT OF APPROPRIATION NO. FOR
tonic.BOAAe.er►AxOrLM Oe M9. ON)
V SPEE OMI;TEA AUTO
DATE FROM TO I^ READING + NATURE OF BUSINESS TAA EV MILES O
POINT POINT START FINISH PZR MILE
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TOTALS
AUTO LICENSE NO.
* SPEEDOMETER HEADING columns are to be used Only when distance between points cannot be determined by llxed mileage or Official highway map.
Pursuant to Ute provisions and penaltleS of Chapter 155,Acts 1953,1 hereby certify that the foregoing account 13 just and correct,that the amout claimed fs leo y due ter alio�vinq l credits:
n
end that p
art of fps same has been paid.
Date
IVSD
R ..
MAY 0 4 2018
BY:
PRESCRIBED BY STATE BOARD OF ACCOUNTS GEHERAL FORM RO.101 DOBE)
MILEAGE CLAIM a L4
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ac'Me ate. cs eC. J yc�zzy ac.)� 7
I PoActs
ON ACCOUNT OF APPROPRIATION NO. FOR
Comm BOARD.DEFARruw On R18U.NnON)
FROM TO SPEMROJQ+ AUTO
bum POINT POINT START FINISH NATURE OF BUSINESS TRAVELED ® �
PER MILE
TAI T
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f
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 claimZiegy d ,after allow all just credits
and that n > ° e has been paid. N ,
Date
0� RECEIVEC� ply
)Z
MAY 0 4 2010
BY: