217820 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
j \`1 ONE CIVIC SQUARE DENEYSE SOLAZZO
CARMEL, INDIANA 46032 14151 PEPIN PLACE CHECK AMOUNT: $186.80
CARMEL IN 46032
CHECK NUMBER: 217820
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 186 . 80 TRAVEL FEES & EXPENSE
=MC=D By STATE SO" °&CCOU19n ==^=XW= =*w
xacEaG*Fc�oJm
ru_--_-_--_u -----
`
--------- -------------- ow^0000x,os APPROPRIATION NO. _- rnu __
DATE FRONJ TO SPFEDO'AFTER AUTO MILEAGE
OINT POWT PER MILE
LL it
TM
AUTO LICENSE NO. TOTALS
-___--_- --'
+ opoEoowErEn nsaoomG columns are muoused only when am° =b"'°~,uv"m*"on"n/ b,u"te,mm"y by fixed mileage",official high°" m"p.
U.
Pursuant m the provi*=.and penalties of Chapter 1ss.Acts 1aa./hereby certify ONO the m,"«"inn"=="""/is'"*azid correct.m"'the"
"=u'a"' 'of ilia�m° h��e"n"�.
-'
Date
FEB 19 2013
Ar
rsofcamn IT sux BOARD of s000aoes
ossaAU,roaw>to.im(Rep
MILEAGE CLAIM
ro Ucan�vtSr� Su V&azy
Olt ACCOUNT OF APPROPRUtnON NO VOR
DATE FROM TO
MAR NATURE OF 1VSQi3 POINT POINT ST Yom AUTO
'Tth r Plta 11M
1 i •� 72
2 C S 72
Mc�
KC.c `3 33
S.(' S 3. u
CL r
MC(, •e _ t
. r
1 15 C-L
MC.C- MT _1•1 S 3. . t
T I. 81
1�
1
3
1 21 hIGC
L Z
_ 11
2 3 T M �« ;�
2-t- tAcC_
5 is tl
2'g
2 r
� �. o 'S S.v 3. i
AUTO UCENSR NO. 3•
+ SPE=Mr=MMING columns ere to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and panalties of Chapter 155,Acts 1893,I hereby certify that the ioregoiztg account is Just end correct.that the amount claimed to legally doe,oiler allowing all Jest credits: '
end that no part of the same has been paid.
Date_�
J
7FEB 19:2 013
ar Bmrs Boron or Acomm
MILEAGE CLAIM COMM mm Ba,a am
TO O QVl Q �UV(`Z Z6
ON ACCOUNT OF APPROPRIATION NO poll
DATS FROM
POINT TO + AUTO
1-7 POINT START FlfIIBN NATUU OP RtISRt= )Qf,BS ® hauu � t
\ M� CL TRAVJQ.1;o
PU
t
2 1 S•e 3• ((
Kc-c-
2 2
M cC- S i
12 M«
Mr e t'S b S3
3
I -
AUTO IC6NSE NO.
TOTAIS
+ SpEBDO1drm READING colnasns an to be used only whoa diBtaace between 1 2�. 58
lm�cannot be determined by fired mileage or official highway map.
Parsnnat to the the gwoao and panaltl-of Chapter'SS,Acts 1893,I hereby certify that the foregoing account is 1=1 and correct,that the amnuat el
end that no p of Batae hes been paid. due after allowing aWf Is.-Date 13
19 2013
DD yx:
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.
364715 Solazzo, Deneyse Terms
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) PO# Amount
2/15/13 Reimb Mileage 12/27/12 -2/19/13
$ 186.80
Total $ 186.80
I 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.
Allowed 20
364715 Solazzo, Deneyse
14151 Pepin PI
Carmel, IN 46032 In Sum of$
$ 186.80
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
Board Members
PO#or INVOICE NO. CCT#/TITL AMOUNT
Dept#
1081-9 Reimb 4343000 $ 186.80 bill(s)is (are)ftrue or
and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
21-Feb 2013
Signature
$ 186.80 Accounts Payable Coordinator
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I