220432 05/22/2013 CITY OF CARMEL, INDIANA VENDOR: 366239 Page 1 of 1
ONE CIVIC SQUARE MONICA HADDOCK
CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $66.19
CHECK NUMBER: 220432
1ron°`
CHECK DATE: 5/22/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 66 . 19 TRAVEL FEES & EXPENSE
PRESCRIBED HT STATE BOARD OF ACCOUNTS GENERAL FOAM 140.101(1906)
,r MILEAGE CLAIM �- j bddz)C
_ (OOVEANNENTAL.U1 ON ACCOUNT OF APPROPRIATION NO. FOR
(OFiICE,HOARD.DEPAATI3,1(r OR IN5T(TlfT10N)
- SPEEDOMETER AUTO MILEAGE
FROM TO I READING � <
DATZ
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED p �
CT
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�C
�0 C
-7 11 119
MCCA
------ -- LV
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I _
AUTO LICENSE NO. TOTALS uo%IL-o
+ 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 is legally due,after allowing all just credits
end that no art of the same has been paid n �j
Date �_��
�� MAY 2013
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.
366239 Haddock, Monica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/3/13 Reimb Mileage 4/8 - 5/3/13 $ 66.19
i
Total $ 66.19
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.
366239 Haddock, Monica Allowed 20
In Sum of$
$ 66.19
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-2 Reimb 4343000 $ 66.19 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
16-May 2013
Signature
$ 66.19 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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