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HomeMy WebLinkAbout155323 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1 ONE CIVIC SQUARE JENNIFER HAMMONS CARMEL, INDIANA 46032 1647 WELCHWOOD CR, APT 269 CHECK AMOUNT: $567.45 INDIANAPOLIS IN 46260 CHECK NUMBER: 155323 CHECK DATE: 111012008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1046 4343000 561.45 TRAVEL FEES EXPENSE PRESCRIBED BY STATE BOARD OF ACCOUNTS GENFRAL FORM NO. 101 (1986) MILEAGE CLAIM j Y,' DEPT Q �U To n7 (GOVERNMENTAL'UNTT) q M 3 O DD ON ACCOUNT OF APPROPRIATION NO_/� FO i (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) FROM TO SPEEDOMETER AUTO MILEAGE DATE READING NATURE OF BUSINESS MILES o �Q7 POINT POINT START FINISH TRAVELED PER MILE J to lc eecs on On �J. ksCi�ss� \cs a t 30 s� C QC"- l g t v 1 ice Gv�ct�n Sow,; l g �LA AUTO LICENSE NO. TOTALS a��. 9 1O SPEEDOMETER READING columns are to be used only when distance between points cannot he '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 le ill 15, after allowing all just credits and that no part of the same has been paid. Date 1; 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 a a o M 0 y Allowed 19 Q a M M in the sum of b c`�o M N a D a tr EA a m (0 N 0 07 CD a 9L 0 0 0 `C N (Board or Commission) P. M n ZT 0 a FILED m AI m p w (D 0 in a M (Official Title) 0 o o M (D 'd A.E. BOYCE CO., INC. MUNCIE, IN 01136 Q+ PRESCRIBED BY STATE BOARD OF ACCOUNTS D� T r. GENERAL FORM NO. 101 (1986) DEPT I' (�h MILEAGE CLAIM DEC 0 6 20 07 1 Q Q_lL.� TO IN (GOVERNMENTAL UNIT) �0S ON ACCOUNT OF APPROPRIATION N I F '�C (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) SPEEDOMETER AUTO MILEAGE DATE FROM TO READING NATURE OF BUSINESS MILES q%, o o a.Oa POINT POINT START FINISH TRAVELED PER MILE v 2- V 2j 3a w -4 �5 to �t ao t s.� a� a� Oct s c,_ k ©ct Oc�k a_ ff AUTO LICENSE NO. TOTALS L4 O'K lP 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 ue, after allowing all just credits 2nd that no part of the same has been paid. Date PRESCRIBED BY STATE BOARD OF A C C O U N T SD E C 2��7 GENERAL FORM NO. 101 (1986) DEPT MILEAG,:! CLAIM LINE L (GOVERNMENTAL UNn) r(1 t� DE SC l/�Y ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) SPEEDOMETER p,� FROM TO READING M ILE S M49� Is POINT POINT START FINISH NATURE OF BUSINESS TRAVELED PER MILE i w I �lw z o (lcv 2i Z� 3 �4 AUTO LICENSE NO. TOTALS SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixedd 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 legall d after allowing all ju t c edits 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. I That it is duly authenticated as required by law That it is based upon statutory authority. That it is apparently correct f incorrect I Disbursing Officer On Account of Appropriation No. for o W A) a En Q. p p w m 0 n En o N a Allowed Ig__ cD Q k n a in the sum of t? 'Q m m En w m a tr a M a CD m O N (D m p a CL L o 0 tr 0 (Board or Commission) o a. cD FILED (D a m N fD m a m a y a rn (Official Title) O m O R I o m !�!yy P t A.E. BOYCE CO., INC. MUNCIE, IN 01136 I a I II ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL i' 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. Jennifer Hammons Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/5/07 Reimb Request Mileage reimb. July -Aug 226.98 12/5/07 Reimb Request Mileage reimb. Aug -Oct 226.98 12/5/07 Reimb Request Mileage reimb. Oct -Dec 113.49 Total �$56 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 i Voucher No. Warrant No. Jennifer Hammons Allowed 20 In Sum of 567.45 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 Reimb Req 4343000 567.45 1 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 4 -Jan 2008 ig at re 567.45 Business rvices Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund