183637 03/25/2010 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE
CHECK AMOUNT: $299.50
INDIANAPOLIS IN 46220 CHECK NUMBER: 183637
CHECK DATE: 3/25/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 299.50 TRAVEL FEES EXPENSE
PRESCRIBED HT STATE BOARD OF ACCOUNTS
GENERKL FORM NO. 101 (190&)
MILEAGE CLA I T� t. My— DIE O d
ennf�e.' t 1�mrn���
tGOVERNMENIAL UNI17
ON ACCOUNT OF APPROPRIATION NO FOR
tOFi7cP, aoARD, DEPARrazu ON INsnftmos)
DATE
FROM TO I S PEED OM ET ER
,AUTO unv MILES ER Q UA GE
a
,r
NATURE OF BUSINESS TRAVELED
POINT POINT START FINISH PER MILE
3 av, w C
c w
5 w
AUTO LICENSE NO- TOTALS W
SPEEDOMETER HEADING 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 lega ly dua, aft r aliowinq j credits
and that no part of the same has been paid.
I� f
Date
Oyu i;iR 7 2010
kayo...................
BY:
PMCRIBED By STATE BOARD OF ACCOUNTS GEKFJi AL FORW IIO. 101 (1905)
MILEAGE CLAIM
FO TRAVE MR
1
(GOVERNMENTAL LWM ON ACCOUNT OF APPROPRIATION NO. FOR
(or HOARD, DETARnay-F OR INsmurlos)
SPEEDOMETER kLlkHr )"UAGE
DATE
FROM TO READING NATURE OF BUSINESS !!5 0 f
POINT POINT START FINISH PER MILE
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t�
1
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AUTO LICENSE NO. TOTALS
SPEEDOMETER HEADING 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 aliowing all just its
end that no part of the s m has been paid. r
Date
BY:
PFMCRIBM HT STATT BOARD OF ACCOUNTS GDERAL FORW NO. 301 (4906)
MILEAGE CLAIM
ro AY TRS L M? Qm
r
2 rl n tt -e,�' G rn ►��v�
tOOVFRNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFiICY, BOARD, DFPAATI4]fT OR INST[tV[lONJ
S EHDOMETER
DATE FROM TO I READING AUTO MILZAGE
�A NATURE OF BUSINESS MILES 5 5 C
POINT POINT START FmrsH THAVELED PER MII�
C C
o-n 1 L I U O
a I Io
I SR c I o
1 `J'i G T0.r v
9 cam_—
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l oL q v y\c nc. i rr o 10 c f �o r
I 7 4 N
l 1 -J C 9 ti
t t C, Lk 4C?
t'
AUTO LICENSE NO. TOTALS 1
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after Bowing all
and that no par o f t e same has been paid.
Date
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
358411 Hammons, Jennifer Terms
634 Northview Ave Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or blll(s)) PO Amount
315/10 Reimb. Mileage 1110 3/5110 195.00
315110 Reimb. Mileage 1211 12/23/09 104.50
Total 299.50
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
z0_
Clerk- Treasurer
i
Voucher No. Warrant No.
358411 Nammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
299.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -10 Reimb. 4343000 195.00 1 hereby certify that the attached invoice(s), or
1081 -1 0 Reimb. 4343000 104.50 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
25 -Mar 2010
Signature
299.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund