223485 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 366663 Page 1 of 1
0 ONE CIVIC SQUARE AMANDA GILLIM
CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $116.68
''rot CHECK NUMBER: 223485
CHECK DATE: 8/2712013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 50 . 52 TRAVEL FEES & EXPENSE
1082 4343000 REIMB 66 . 16 TRAVEL FEES & EXPENSE
CE1Vr--D
1115 I'll
PRESMAtO BY STATE ZOAXD OF A=0CM I/ MILEAc CLM
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ON ACCOUNT OF APPROPRIATION No. FOR
jOEFFMCF.bOARD,VE?ARTb0xr ox lmsrmnlos)
FROM TO AUTO
READING NATURE OF BUSINESS ?C
POINT POINT START FINISH MIM PER NILE
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AUTO LICENSE NO. TOTALS
L 50
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determinod by lixed.mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1053,1 hereby certify that the InTegoing account is just and correct,that the amount claim ly d a,after aliowin au fast red is
end that S been paid.
Date
Oq ell
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ON,
R E C F�,I V D
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AUG 15 2013
VU-SCRIBED BY STATE ROAK0 OF ACCOUNTS GEKFAIA FOXW W, IN 09SE1
BY
7BY
MILEA(-',F, CLAIM
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t A{NxENTA{-IJNiTI ON ACCOUNT OF APPROPRIATION NO. FOR
tO7210E•bOARD.DEPART90a 011 196 108)
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FROM TO t READING If
D Ty POINT POINT START FINISH NATURE OF BUSINESS TRAVELED PER MILE
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AUTO LICENSE 110. 2 TOTALS 1--6i 6
Rn7'T—"tTER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map,
Is Ieqp y lill0i'dill" Iiltl re
to the provisions and penalties of Chapter 155,Acts 1953,1 hereby C@Ttity 6di the fnTpgo;ng a=r-ount is just and correct,that the amount claimed I I It due at
I that ppr)pl Trno has been paid.
AI P11
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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
366663 Gillim, Amanda
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO# Amount
5 50.52
8/13/13 Reimb Mileage 4/18 - 5/21/13 8 66.16
8/13/13 Reimb Mileage 5/21 - 8/13/13
MTotal $
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.
366663 Gillim, Amanda Allowed 20
e
In Sum of$
$ 116.68
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1081-5 Reimb 4343000 $ 50.52 1 hereby certify that the attached invoice(s), or
1082-12 Reimb 4343000 $ 66.16 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
22-Aug 2013
signature
$ 116.68 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund