225561 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
. � ONE CIVIC SQUARE DENEYSE SOLAZZO CHECK AMOUNT: $218.60
CARMEL, INDIANA 46032 14151 PEPIN PLACE
'ti,�uM gip. CARMEL IN 46032 CHECK NUMBER: 225561
CHECK DATE: 10/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 159 . 10 TRAVEL FEES & EXPENSE
1082 4343000 59 . 50 TRAVEL FEES & EXPENSE
OCT � 5 2013
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM N0I101 rt"6)
MILEAGE CLAIM ,n ` BY" - — ---.
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AUTO LICENSE NO. T TOTALS �� q
+ 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 ving all just credits
and that no part of the same has been paid.
Date
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OCT 15 2013
PAPSCAIBED BY STATE BOARD Or ACCOUNTS GENFAAL FORM NO.101(t986)
MILEAGE CLAIM CC pp BY-
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(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(092iCE,BOARD,DEPARTMENT OR 1NRTT7UTION)
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+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Q O
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foTOgoing account is just and correct,that the amount claimed 1s after allowing just credits.
and that no part of the same has been paid.
Date
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+ 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 1953,1 hereby certify that the foregoing account is just and correct,that the amouni claimed is due,after aliowing a lust cr
end that no part of the same has been paid.
Date
f�
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 invoice(s) or bill(s)) PO# Amount
10/10/13 Reimb Mileage 7/10 - 8/2/13 $ 59.50
10/10/13 Reimb Mileage 8/5 - 10/10/13 $ 159.10
Total $ 218.60
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.
364715 Solazzo, Deneyse Allowed 20
14151 Pepin PI
Carmel, IN 46032
In Sum of$
$ 218.60
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-12 Reimb 4343000 $ 59.50 1 hereby certify that the attached invoice(s), or
1081-9 Reimb 4343000 $ 159.10 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
17-Oct 2013
Signature
$ 218.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund