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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 X kk I monon —1 ex Mo mrn A C-- I Q NNC k-4 1 fn !I , i -4 f—n0r)Vn CsDa"]L-S-- 'i \NYCnoo, \"JCL t 14 -1(4 -\N I C" 13 40 I LA -A Aq -21 14 IQP ILI Q, L 14 S 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 L oroY.• (1�a� o I I o CiY,c,n. l0 y ON 1 O V r� L o? 5 w-P-n \ C. CY,\O-V\ CN 4 f\CO i C \ _ C o7 1 \ t 1 n L , V l i on • s i _ 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