157625 03/19/2008 CITY OF CARMEL, INDIANA VENDOR: 354940 Page 1 of 1
ONE CIVIC SQUARE THOMAS PERKINS
CARMEL, INDIANA 46032 14`150 EQUINE COURT CHECK AMOUNT: $82.12
WESTFIELD IN 46074
CHECK NUMBER: 157625
CHECK DATE: 3/19/2008
DEPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIP
1180 4343003 22.95 TRAVEL LODGING
1180 4343004 48.97 TRAVEL PER DIEMS
1180 R4343003 17855 10.20 REIMBURSEMENT
STATE OF INDIANA
SS:
COUNTY OF HAMILTON
AFFIDAVIT
I, Thomas D. Perkins, Carmel Assistant City Attorney, being first duly sworn upon my oath, state
that while attending litigation mediation on behalf of the City on February 6, 2008, I expended $7.00 of
my own money for parking expenses and for which I need to be reimbursed.
Dated this day of February, 2008.
oAm D. Perkins
Subscribed and sworn to before me, the undersigned Notary Public, this day of February,
2008.
A. Elaine ass, NOTARY PUBLIC
Resident of Johnson County, Indiana
My Commission Expires:
October 23, 2008
leb:msivord.z �shued\affrdavits\affadivit- parking perkinsAm 2 /29/081
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.
Thomas D. Perkins Payee
Purchase Order No.
14150 Equine Court
Terms
Westfield, Indiana 46074
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2 -29 -08 Reimburse Thomas D. Perkins for monies he $22.95
personally expended while on City business per the
attached
Total
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. $22.95
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Thomas D. Perkins IN SUM OF
14150 Equine Court
W estfield, Indiana 460
$22.95
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
430 -43003 Non Training
Board Members
DE -f' INVOICE NO. ACCT #!TITLE AMOUNT 1 hereby certify that the attached invoice(s), or
1180 22.95 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
20 19
r I nature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
STATE OF INDIANA
SS:
COUNTY OF HAMILTON
AFFIDAVIT
I, Thomas D. Perkins, Carrnel Assistant City Attorney, being first duly sworn upon my oath, state
that I while on City business I expended my own money for the following expenses:
1. Attending an oral argument in City litigation on March 8, 2007, in Indianapolis, Indiana, I inserted $2.20 into a
parking meter;
2. Attending a settlement conference in City litigation on December 12, 2007, in Indianapolis, Indiana, I
expended $8.00 for parking;
for a total of $10.20 and for which I need to be reimbursed.
Dated this day of December, 2007.
/homas D. Perkins
tk
Subscribed and sworn to before me, the undersigned Notary Public, this day of December,
2007
A. Elaine Bass, NOTARY PUBLIC
Resident of Johnson County, Indiana
My Commission Expires:
October 23, 2008
eb: naword :z:Nshnred�affidavits\affadirit- parking perkins.do 12 /18/07]
L
hraibed bF State Board o: Acootmu.
3—ral Form No. 101 agora
MILEAGE CLAIM
(GOVERNMENTAL UNIT) TO
DR.
ON ACCOUNT OF APPROPRIATION NO. OO FO
(OFFICE. B DEP T OR INSTI
DATE FROM TO SPEEDOMETER AUTO M'LF,Q
READING+ MILES
NATURE OF BUSINESS TRAVELED @ER MILE
POINT POINT START FINISH
os•1 zi4L Q 39, 1621
AUTO LICENSE NO. TOTALS I
+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 creel
and tha no part of the same has been paid.
Date
VOUCHER NO. WARRANT NO.
ALLOWED 20
Thomas D. Perkins
IN SUM OF
14150 Equine Court
Westfield, Indiana 4 607 4
$22.95
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
430 -43003 Non Training
Board Members
oE INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
1180 22.95
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
p� 20 0 0
i nature
Cost distribution ledger classification if Title
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.
Thomas D. Perkins Payee
Purchase Order No.
14150 Equine Court
Terms
Westfield, Indiana 46074
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2 -29 -08 Reimburse Thomas D. Perkins for monies he $22.95
personally expended while on City business per the
attached
Total
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. $22.95
20
Clerk- Treasurer