HomeMy WebLinkAbout180106 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK AMOUNT: $172.25
INDIANAPOLIS IN 46220
CHECK NUMBER: 180106
CHECK DATE: 1218/2009
DEPARTMENT ACCOUNT PO N INV OICE N UMB ER AMOUNT DES
1046 4239040 23.20 FOOD BEVERAGES
1046 4343004 149.05 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOAA i ACCOUNTS
GENERAL FORM 110. 101 f1906j
MILEAGE CLAIM
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTLQarr OR INSTITUTION)
20 FROM TO I S READ NG }R AUTO E
POINT POINT START FINISH NATURE OF BUSINESS MILES ED f
PER MILE
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AUTO LICENSE NO. TOTALS 1
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 isle ally a, after alio ing all t credits
and that no part of the same has been paid.
Date
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Primary ACCOUn"t Debit
ATM/DEBIT CARD TENDER 24.41
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NUMBER OF ITEMS 20
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Visit us at
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User ID:011
Password:032401071
Survey shoul be completed within 72 hrs
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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.
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
11/3/09 Reimb. Mileage 9/1 10/28/09 149.05
11/20/09 Reimb. Parents night out 23.20
Total I 172.25
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
Voucher No. Warrant No.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of
172.25
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 149.05 1 hereby certify that the attached invoice(s), or
1046 Reimb. 4239040 23.20 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
r which charge is made were ordered and
received except
3 -Dec 2009
Signature
172.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund