HomeMy WebLinkAbout226690 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 358411 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HAMMONS
CARMEL, INDIANA 46032 634 NORTHVIEW AVENUE CHECK AMOUNT: $192.10
INDIANAPOLIS IN 46220
CHECK NUMBER: 226690
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 192 . 10 TRAVEL FEES & EXPENSE
NOV- 19 2013
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.10)(1996)
MILEAGE CLAIM
(GOVERNMENTAL UNITI
C ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMM"OR INSTITUTION)
SPEEDOMETER
D TE FROM TO HEADING {- AUTO MMEAG
2� POINT POINT START FINISH NATURE OF BUSINESS TAMIL ED @ S(oS I
PER MILE
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AUTO LICENSE NO. TOTALS
+ 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 al- lowing all ius edits
and that no part of the same has been paid. `^J\�J_�
Date �� �� l �t--
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.
358411 Hammons, Jennifer Terms
634 Northview Ave Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
11/15/13 Reimb. Mileage 7/23- 10/31/13 $ 192.10
Total $ 192.10
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
i
Voucher No. Warrant No.
358411 Hammons, Jennifer Allowed 20
634 Northview Ave
Indianapolis, IN 46220
In Sum of$
$ 192.10
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1081-10 Reimb. 4343000 $ 192.10 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
27-Nov 2013
Signature
$ 192.10 ACCOUnts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund