HomeMy WebLinkAbout210881 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
s ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $330.23
` CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE
INDIANAPOLIS IN 46220 CHECK NUMBER: 210881
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 330 .23 TRAVEL FEES & EXPENSE
PRESCRIBED By STATE BOAXD OF ACCOUNTS GENERAL FORM 14C 101(1906)
MILEAGE CLAIM k
T.:I—��; H OIMCOO()—!,
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO.— FOR
(OFIICE•BOARD.DEFAATMXtff OR 1"STTTUTION)
FROM TO
DATE SPEEDOMETER AUTO MILEAGE
READING + NATURE OF BUSINESS MILES
RAVELED
POINT POINT START FINISH -F PER MILE
4 LA
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AUTO LICENSE NO, TOTALS C)9a W6 95
+ 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 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally dye,after alio)(in�just crpd?#A
end that no part of the same has been paid
Date C� ca
C-
rBIY:JUN 2 7 2012
FRffiCRIHED BY BLUE BOARD OF ACCOUNTS GM MU FORM NO.101(1006)
MILEAGE CLAIM
TO-
(GOVSKIOWnAL DN1T)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFx.R'.BOARD,DEPARTMENT OR ON)
DATE FROM TO SRE OMIMER AUTO I 9!
POINT POINT START FINISH NATURE OF BUSINESS TRAVE ® PHR MM •S
MILE
a C c-, wc- 11-114
Lk t c-,-, \I\jc- 144
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oroY.• (1�a� o I I
o CiY,c,n. l0
y
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AUTO LICENSE NO. TOTALS Q l l a 0
+ 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 1893,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing lust c edi s
and that no part of the same has been paid.
Date c� a s , a V�
''JUN 2 7 2012
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
6/25/12 Reimb. Mileage 1/3 -6/15/12 $ 330.23
Total $ 330.23
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$
$ 330.23
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1081-10 Reimb. 4343000 $ 330.23 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
12-Jul 2012
Signature
$ 330.23 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund