HomeMy WebLinkAbout212612 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS CHECK AMOUNT: $148.74
CARMEL, INDIANA 46032 634 NORTHVIEWAVENUE
INDIANAPOLIS IN 46220 CHECK NUMBER: 212612
CHECK DATE: 9112/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 148 . 74 TRAVEL FEES & EXPENSE
AUG 2 9 2012
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM 110 101 11906)
MILEAGE CLAIM
To (1�f1
(GOVERNMENTAL UNrr)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT ON INsTrnrnoN)
FROM TO SPEEDOMETER DATE MILEAGE
DATE READING +
2-�
POINT POINT STAR7 FINISH NATURE OF BUSINESS TRAVELED MILES —'�°`' r
PER MILE
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AUTO LICENSE NO. TOTALS t /- B 14 9 `7
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. WW
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just a�correct, that the amount claimed is legally due after aliowing )ust c dit%
and that no part of the sa a has been paid. '� /�
Date 0 I (
O" � / 9 -1
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
8/18/12 Reimb. Mileage 6/20 - 8/3/12 $ 148.74
Total $ 148.74
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$
i
$ 148.74 i
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 Reimb. 4343000 $ 148.74 i 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
6-Sep 2012
Signature
$ 148.74 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund