HomeMy WebLinkAbout156607 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
f ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 1847 WELCHWOOD CR, APT 289 CHECK AMOUNT: $559.77
INDIANAPOLIS IN 46260
CHECK NUMBER: 156607
CHECK DATE: 2/21/2008
DEPARTMENT ACCOUNT P O NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 23.26 CLUB ACTIVITY SUPPLIE
1046 4239039 14.00 GENERAL PROGRAM SUPPL
1046 .4343000 522.51 TRAVEL FEES EXPENSE
1 qfo REC Y E D GENERAL FORM NO. 101 (1986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS G l.` �C/
MILEAGE CLAIM JAN 2 5 2008
TO
(GOVERNMENTAL UNIT) BY• 1
ON ACCOUNT OF APPROPRIATION NO.
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING e
a� MILES 4% S
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
Z VJ C \fob tcb c.� L,� �p•ro,r �r�i C.,_ 38
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AUTO LICENSE NO. TOTALS �U ICJ
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 a;count is just and correct, that the amount claimed is legally due, after allowing all just credits 1'O
and that no part of the same has been paid.
Date Q
.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. BOYCE CO, INC. MUNCIE. IN 01136 ,C Z a
i I
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CT ATI.! �CEIvED GENERAL FORM NO. 101 (1986)
LT011vl
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROP N NO OR c-Mmc-y\s
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE
FROM TO READING AUTO MILEAGE
NATURE OF BUSINESS MILES 6, x
POINT POINT START FINISH TRAVELED p MILE
1 c
Cl a wc— 1
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t C� l—o G M C Cl?
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t\ t
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C YY\oy\c l'X_
l t W G 13 K
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 credits,
end that no part of the same has been paid.
Da te
Claim No. Warrant No. I have examined the within claim and hereb}
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o W
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A.E. EOYCE CC., INC. MUNCIE, IN 01136
Ca rmel Clad/ 2
JAN 3 2008
Parks &Recreation
to ee Expense Reimbursement Request 2
Employee Em
p Y
Date of Fund Account Account
6] Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
(U`q(9 423`iO39 C (Y 00 Y
fNN'l receipts
o sales should be attached in the same order as listed above.
es tax will be reimbursed. TOTAL:
Employeen Name (print) IJ P—A(\ �41 V� irnq�S
Address t We.(C_.k Wo
oO Ci'r Zs�
Check
payable to: City, St, Zip r1(� i c�v\ck.p dt i� 5 l !v 't� (9 (3
Signature: Approved by:
Date: t Q Date:
Revised 3 -2 -07 by Business Services;
Shared /Forms and Templates /Business Service Forms /Employee Exp Reimb Request 2007 -3
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 p unit, etc.
Payee
Purchase Order No.
Jennifer Hammons Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/15/07 Reimb Request Mileage reimb. 334.65
1/22/08 Reimb Request Mileage reimb. 187.86
1/22/08 Reimb Request ESE supplies 23.26
1/22/08 Reimb Request ESE supplies 14.00
Total 559.77
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
20_
Clerk- Treasurer
i
Vour- Er No. Warrant No.
Jennifer Hammons Allowed 20
In Sum of
559.77
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1046 Reimb Req 4343000 522.51 1 hereby certify that the attached invoice(s), or
1046 Reimb Req 4239037 23.26 bill(s) is (are) true and correct and that the
1046 Reimb Req 4239039 14.00 materials or services itemized thereon for
which charge is made were ordered and
received except
13 -Feb 2008
S4dnat
559.77 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund