330686 10/02/18 'y �,q3� CITY OF CARMEL, INDIANA VENDOR: 372278
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.I; ONE CIVIC SQUARE ANTHONY FLETCHER CHECK AMOUNT: $******"*14.72*
d�� J��; CARMEL, INDIANA 46032 3817 COOPER SQUARE CT CHECK NUMBER: 330686
�,��oN�. APT 11202 CHECK DATE: 10/02/18
INDIANAPOLIS IN 46205
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 14.72 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 372278 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Fletcher, Anthony Payee
3817 Cooper Square Ct, Apt 11202
Indianapolis, IN 46205 In Sum of$ Purchase Order#
372278 Fletcher, Anthony Terms
$ 14.72 3817 Cooper Square Ct, Apt 11202 Date Due
Indianapolis, IN 46205
ON ACCOUNT OF APPROPRIATION FOR
108-ESE
PO#or Invoice Description
Dept# INVOICE NO. ACCT#InTLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-2 Reimb 4343000 $ 14.72 Board Members 8/22/18 Reimb Mileage 5/14-8/20/18 $ 14.72
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
$ 14.72 Total $ 14.72
September 25,2018
1 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
e w
- i
PRESCRIPED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.101(1906)
MILEAGE CLAIM
TO-
(GOVERNMENTAL UNW1 ON ACCOUNT OF APPROPRIATION NO. FOR
tonICE,HOARD,DEPARTMv"-oq TNsrMyriON)
SPEEDOMETER AUTO IAMEAGE
DATE FROM TO READING .I- NATURE OF BUSINESS TRAVELED PER f
J..�— POINT POINT START FINISH PER MILE
n
�ncn
14
20 na b
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 allowing all just credils,
Pud that no party rof the same has been paid.
Dates l L G�� 0
BYE___ .�