HomeMy WebLinkAbout221072 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 366239 Page 1 of 1
ONE CIVIC SQUARE MONICA HADDOCK
CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $160.53
CHECK NUMBER: 221072
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 160 . 53 TRAVEL FEES & EXPENSE
Jul 04 2013
GENERAL FORM NO.181 11986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS
8y; _. MILEAGE CLAIM
TO
—
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
GaJ
(OFiICE,BOARD,DEPARTI6]fF OR INSnTUrION)
SPEEDOMETER AUTO MIL-EAGGE
D T FROM TO READING + NATU�OF SIN ESS MILES a
zO POINT START FINISH TRAVELED PER MILE
POINT
-----
LC-
--
/ -
it i'WT
CT
-- C'
AUTO LICENSE NO. TOTALS a I
+ 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 aliowing all just credits
and that no[ail of the same has been paid.
Date
L
I �
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.
Terms
366239 Haddock, Monica
Invoice Invoice Description PO# Amount
Date Number (or note attached invoice(s) or bill(s))
$ 160.53
5/31113 Reimb Mileage 5/6 - 5/31/13
Total $ 160.53
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.
366239 Haddock, Monica Allowed 20
In Sum of$
$ 160.53
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1081-2 Reimb 4343000 $ 160.53 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
13-Jun 2013
Signature
$ 160.53 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund