HomeMy WebLinkAbout201241 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
t, ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE
CHECK AMOUNT: $246.33
INDIANAPOLIS IN 46220 CHECK NUMBER: 201241
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 179.52 TRAVEL FEES EXPENSE
1082 4343000 REIMB 66.81 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS I GENERAL FORN NO. IDI (1Wfi)
MILEAGE CLAIM V) e.
TO
(GOVERNMENTAL U)tl) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTIONS
FROM TO SPEEDOMETER AUTO MILEAGE
READING c y
MILES
z� POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS Y
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 jus edits
end that no part of the same a has been paid.
Date t�L-
D 3y I a
xt 3 2011 I;
PRESCRIBED HT STATE BOARD OF ACCOUNTS
GENE11ALFORM 170. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR r
e
(OF2ICE, BOARD, DEPARTMENT 08 1NSlTMiON)
SPEEDOMETER
DATE FROM TO I READING AUTO E
NATURE OF BUSINESS MILES Q c
POINT POINT STRRT FINISH TRAVELED PER MILE
1
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a o...
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h c I d
AUTO LICENSE NO. TOTALS Q
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 dits
and that no part of the same has been paid.
Date
o L[[ ,q�.tr� 1�
n o
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.
I
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 bill(s)) PO Amount
8/19/11 Reimb. Mileage 3/28 5/31/11 179.52
8/19/11 Reimb. Mileage 6/1 6/29/11 66.81
Total 246.33
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
Voucher No. Warrant No.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
246.33
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1081 -10 Reimb. 4343000 179.52 1 hereby certify that the attached invoice(s), or
1082 -1 Reimb. 4343000 66.81 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
8 -Sep 2011
Signature
246.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund