HomeMy WebLinkAbout330681 10/02/18 CITY OF CARMEL, INDIANA VENDOR: 369160
I; \• ONE CIVIC SQUARE MAX ELLIS CHECK AMOUNT: $********42.13*
CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 330681
M„ioN CHECK DATE: 10/02/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 42.13 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 369160 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Ellis, Max Payee
1821 Marion Drive
Indianapolis, IN 46240 In Sum of$ Purchase Order#
369160 Ellis, Max Terms
$ 42.13 1821 Marion Drive Date Due
Indianapolis, IN 46240
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT nvo,ce Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-9 Reimb 4343000 $ 42.13 Board Members 9/7/18 Reimb Mileage 2/28-9/6/18 $ 42.13
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
$ 42.13 Total $ 42.13
September 25,2018
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
NN 2-Ni
GENERAL FORM NO)PI 119M
PMSCMDED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
1 EANMENTAL UNI71 ON ACCOUNT OF APPROPRIATION NO. FOR
IOMCL LARD.DVARTMOn OR INSMIXTION)
PEEDOMETER AUTO MILEAGE
DATE FROM TO I^ HEADING + �SIPS
NATURE OF BUSINESSMILESMILES 0 —
�tt POS POWT START FINISH PER MILE
2 S
CL
S 1 M• M L r T n 7
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1 t� S
s L _ M r IQStN r Ios S 7
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i r t 16,5 S
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AUTO LICENSE NO. TOTALSIL
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to 111e provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after al
iolvinq all Iust credits
end hat,norpaxt®of the same has been paid.
Date VI/1`�0 _
5tN252018