Loading...
HomeMy WebLinkAbout330922 10/09/18 �! CITY OF CARMEL, INDIANA VENDOR: 359285 • ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $*******388.03* ,. � CARMEL, INDIANA 46032 2703 E LYNN ST CHECK NUMBER: 330922 gMi7roN.�. ANDERSON IN 46016 CHECK DATE: 10/09/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 238.16 TRAVEL FEES & EXPENSE 1082 4343000 REIMB 149.87 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 359285 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Simmonds, Valeska Payee 2703 E Lynn St Anderson, IN 46016 In Sum of$ Purchase Order# 359285 Simmonds,Valeska Terms $ 3$$.03 2703 E Lynn St Date Due Anderson, IN 46016 ON ACCOUNT OF APPROPRIATION FOR 108-ESE Fund PO#or Invoice Description INVOICE NO. ACCT#/TITLE AMOUNT Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1082-10 Reimb 4343000 $ 149.87 Board Members 9/18/18 Reimb Mileage 4/16-9/19/18 $ 149.87 1081-4 Reimb 4343000 $ 238.16 9/18/18 Reimb Mileage 4/16-9/19/18 $ 238.16 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 $ 388.03 Total $ 388.03 October 1,2018 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance Cost distribution ledger classification if YAHA with IC 5-11-10-1.6 claim paid motor vehicle highway fund Signature -.20_ Accounts Payable Coordinator Clerk-Treasurer Title R,C Fa D 272018 PAFSCAIDED HY STATE BOAPD OF ACCODNiS .. 6z0- BY:.............................. .---- ^Q7RIAL-FOA O.101 f1B0 MILEAGE CLAIM — ��� n (GOVEAIALLNrAL IINTT) ON ACCOUNT OF APPROPRIATION NO. FOR [OFFICE,AOADD,DEPARD.WRT OR DL4nn1T1oN) �►!� FROM TO SPEEDOMETER READING + AUTO MILEAGE POINTPOINT START FINISH NATURE OF BUSINESS MILES TRAVELED l iA C —b`C. 6 4-5 tw n^ PER MILE` MC t— -O — V%A C C, F-0 f- rvICL vV4,v —� M a-f —A L —f L L 11-10 1 rn r- na/-� _ =o f- 'i VYYI vyll _i tMt�r 1—rat AUTO LICENSE NO. TOTALS VL .J14,s + 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 pmthsioas 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 allotvinq a usl credits and at no art of th same h®s bean paid. Dat ,e---`Cry--1 '' G I _ L[ L) 3L) 3 �v�f d38 oZ 3 ; L.� ", -ev p� � � � � IR, �� � I � ✓�Y�cQe�'S� �n L�t�o�(p PRESCRIBED BY STATE BOARD OF ACCODNTS GENERAL FORM NO.101(1986] MILEAGE CLAIM Jeska IM-M ands S ' TO--A 3 qGOVERWdE14TAL DMT) . ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTMENT OB 1NSTITU'TION) p�TG FROM TO SPEEDOMETER READING + ALTO MILEAGE -►a- NATURE OF BUSINESS MILES ® 4 POINT POINT START FINISH TRAVELED PER MILE ` ► 41 J -1 c. -� Foc MCL rV)CL -ro F:5 -ZI r»u, 2 �- -2 �-D f, M -2 L i-t0 s-2ti t -2 Ct cC S-36 C4- -6-13 t r- rn&L C.C. a. tnka v rv► rY► -f- Lo- =0 G (0-1 It N C1 14 AUTO LICENSE NO. TOTALS L + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. y$150 . 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 dits and that no part of the sa as been paid. Date 39 VS U. Y: - -'Y1c6V5ob S, JL/ L���� SEP 217 2010 LE: PRESCRIBED By STATE BOARD OF ACCODNTS GENERAL FOAM NO.101 JINN) MILEAGE CLAIM \ A fl(l �l�� FELSv (GOVEANMER7AL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTMENT OR INSn)7IT)ON) DAT FROM TO SPEEDOMETER -7b�i� READING + AUTO MILEAGE NATURE OF BUSINESS MILES S ® o POINT POINT START FINISHTRAVELED PER MILE �Q= M CL 04L t✓f1,% ion(0 CL CrNA c 2a m G Yvl A �t 44 r- C.,rv) j ,V3 Vv 1;13 Irr _2� G 2 G AUTO LICENSE NO. TOTALS + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mfleage or official highway map. Pursuant to the provisions and enaltles 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 j t credits; and thvt ' p t the same has n paid. Date �� em �� SEP 2 7 2010 � t4b61&9 PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORA NO.10111"5) MILEAGE CLAIM \v f al r _1 S t rO m�S (GOVERNMENTAL MDaT) .� ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTMENT OR INS[MITIONI DATE FROM TO SPEEDOMETER „A READING +. AUTO MILEAGE Fr POINT POINT NATURE OF BUSINESS �At�C START FINISH ED ® a PER MILE M C C L '7- LL _ yyl V-n Ce c -c M !� -IS rmC(- �fJ G,M nrN 2 M GG a M c alM AUTO LICENSE NO. TOTALS 4r 5 + SPEEDOMETER READING Columns axe to be used only when distance between points cannot be determined by fixed mileage or official highway map. (5�.MP . 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 1 gaily due,after allowing all just credits and that no part of the same has been paid. Date 00 1R � . . - E ,r L-tn r\ S 5tN 2 Y 2018 E PRESUMED BY STATE BOARD OF ACCOUNTS n GENERAL FORM no.101(19M MILEAGE C OIM Q�� \l rn n ,ci-S (GOVER ENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTNFM OA INBTiTIII)ON) pZg FROM TO READING +� AUTO MILEAGE POS POINT START FINISH NATURE OF BUSINESS MILES TRAVELED PER MR.E a.if-C-------------- r� w� FO F- -► -1CLL MCL il-Tb 6XVviat Or MCC_L4-20 —Kirofle n u- L -2-w7- m w -i3© +-►�� rn 17041 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 c its: and that no pa tof the�sals has been paid. Date 9-30- � ) 3L 6C>Ll 7 2 . C�+ten �a'S.?; �� e �n L16616 tN 'r 2018 1 Bx: PRESCRIBED BY SPATE BOARD OF ACCOUNTS G6NHIIAL fOpb NO.101 11986) MILEAGE CLAIM ESE— TO V J (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPAmmarr OB INSTRU IONI DATE FROM TO SPEEDOMETER READING + AUTO MILEAGR — POINT NATURE OF BUSINESS TRAVELED ® t POINT START FINISH PER MILE w PQ-rr Fog t •5 CC MACT-7 04- �_ i ► C MGC. M Lt. LL ryti MGC. -to W <S-f MCC_ ..c� p CL R-R rn --t e- ►--pc I"C L C C, -• r Cf f aft 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. �15•�Y 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 juste dits,- rnd that no p of1 9 same(has been paid. Date •• LD 1� L) °� /7 ao3 �. Lyman . rfj., x, . Y��rscV� lb �► b 0 5 t N 2 7 2010�N l B.Y ..................-� PRESCRIBED BY SPATE BOARD OF ACCOUNTS \ 1 GENERAL FOAM NO.101(ism p MILEAGE CLAIM a ������ (GOVERIDeENrAL DNPT] ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE.BOARD,DEPARTMENT OR INSTITUTION) FROM TO SPEEDOMETER r READING + AUTO tdILEAGE POINTES POINT START FINISH NATURE OF BUSINESS TRAVELED ® a a PER MILE -2S -2- otM G -C— ',/1 7v1 L FRV s:— M CIC, — _► -o nnt G — fv.L� — 1 C- fVl fit. - AUTO LICENSE NO. TOTALS 11 1- 1 Vil + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. LIS,- 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 a just credits,- and that p part of the same has been paid. �( Date — 15-1"1 V 1 939 3(309 I Yxrl StN 2 'l 2018 IM ........ PRESCRIBED By SUTE BOARD OF ACCOUNTS - GENEa"FOAN NO.101(INS) MILEAGE CLAIM \ TO a�eS L U (GOVERWENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTF1,111IT OR INS IMION) FROM TO SPEEDOMETER AUTO MILEAGE READING NATURE OF BUSINESS TRAVELED ® POINT POINT START FINISH a PER MILE I �Ib GL- o%- rv►c L -� ML(. w wta f o -ID yV►L -2� mcL EQrL L1 F04 v%4c,L aMar 2� v L CL 22 UV ca C rnCk. -M cc. = e rn cti � 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. L-n 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 a just Credits and that no art^of thesamehas been paid. N YY l Date ' ��✓ IO \�\J L) 3 001