193118 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00350224 Page 1 of 1
ONE CIVIC SQUARE NANCY HECK
CARMEL, INDIANA 46032 CHECK AMOUNT: $456.49
CHECK NUMBER: 193118
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343004 253.55 TRAVEL PER DIEMS
1160 4463100 202.94 COMMUNICATION EQUIPME
Ver izon wireless.
1950 F Greyhound Pass
Carmel, IN 46033 -7730
(317)580 -9548
Order Location: M4912 01 #151639 Pmt 1 of
1
Order Type: IS
Receive Location: M4912 01 Register: 3
12/17/10 13:31 ET sawyeko ELH41 }fie i m b U r S
C
Retail Sale
MOTDRDX3PKASP Price Price �Jo nL q 0 e c-k
SCR:MOT DRDX $14.99 $11.99
MOTDRDXSILHGBLU
CAS:MOT DRDX $19.99 $15.99 )32(v Cod I
JBGO3BD -VZ
BLU:JAWBNE I $99.99 $74.99
DRDY,4PK
COM4: DX PWR $99.97 $99.97
Tax: $0. 3
Total Tax: $0.00
Total: $202.94
Total Savings: $32.00 C G
*Some states require us to compute sales
tax on the full retail price or inventory CC) y --„nr cn, %c.�fi��S
cost of the device you purchase.
This Payment: $202.94 m fi✓L t
v■` XXXXXXXXXXI' m XX /XXXX L yb o
Signature:_
Return Policy:
New and Certified Pre -Owned merchandise
items ma yy only be returned or exchan ed
within 30 days (14 days for Tablets
You are permitted to make one exchange.
A restocking fee of $35 ($70 for Netbooks
and Tablets) applies to any return or
exchange of a wireless device
(excluding Hawaii).
See verizonwireless .com /returnpolicy for
complete
To receive a credit for the activation
.fee, cancellations must occur within
3 days of activation of service.
Thank You
The NEW My Verizon.
All The Tools.
All The Features.
More Convenience.
Visit verizonwireless.com for more.
Visit www.Verizon4 to
tell us about your experience.
M I I S M 491 201 0001 51 099
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM t Gj�_
TO—
(GOVERNMENTAL UNIT) I f 3 7�
A' m f ON ACCOUNT OF APPROPRIATION NO- 7 FOR I�f/f Z' PC r -D G A-S Y4 i
(OFFICE, BOARD, DEPARTMENT OR IN ITUTION) Cw
DATE FROM TO SPEEDOMETER AUTO MILE
1 J NATURE OF BUSINESS READING MILES x
r POINT POINT START FINISH TRAVELED pER MILE
YVl fi U) Gt a c K i i k1 I
TV K a K Y)4-e,>° Vf)w R o k 32
2 1 I'YI A0 f13 fO i,UN L, 13 t /woP,K bo 4:i� tzr.oc E FJ
Z 1 LL i I it 'i ss cr d7'_0b16 fV 4e s o tx
2 1 4 u 4 c.1 P L, Woyt 0 r
A i t 2 1 6c, PL, CA a I 1 Pud.94k, f o
tp I L i f I' q I I Mal in rA Xe S41W76 curd ba c, K v1sik plop h k bar) 3
o n I I M 6f i h S f h an b K n 5 1 P_6 0- k 0 obovn C,u hO n
tit 1 Bac,K c wr'b tg rioh lust
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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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after all wing all just credits
and that no part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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A.E. aorce co., INC. taurrcu, IN 01136
W n N
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM r
TO G 'e z
OF Cam
(GOVERNMENTAL UNIT) Z
ON ACCOUNT OF APPROPRIATION NO. J y 0 FOR TY W4 Y bPYY /V 'Tr t
(�'1 Or
UYhi'I'l N h
OFFICE, BOARD, DEPARTMENT OR INSTITU ION)
DATE FROM TO SPEEDOMETER AUTO MILEAGE
1 D READING NATURE OF BUSINESS MILES S�_ c
POINT POINT START FINISH TRAVELED PER MILE
N o v CA 11 s. A 13ac f i e ve o m w Rrrr,J� e
2 (A 14a a K t� 5a K I ch 3
2 c,) Hie /1 1112KOI K" BCIGK J i
PE G ko M Ks 5,," r H& n.g-) f acA- 14 C L A 2 3
Pen
L
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. 2
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 a just credits
and that no part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently I correct
L incorrect
Disbursing Officer
On Account of Appropriation No. for
o W a
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N a
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Allowed 19_ m n a
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in the sum of
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(Board or Commission) 0 m
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(Official Title) O a
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W N
A.E. ROYCE CO., INC. MUNCIE, IN 01136
i
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Nancy Heck
IN SUM OF
1326 Cool Creek Drive
Carmel, IN 46033
$456.49
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1160 Mileage Claim 43- 430.04 $253.55 1 hereby certify that the attached invoice(s), or
1160 Receipt 44- 631.00 $202.94
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
Friday, December 17, 2010
Ma or
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/17/10 Mileage Claim $253.55
12/17/10 Receipt $202.94
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
20
Clerk- Treasurer