HomeMy WebLinkAbout227372 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 366239 Page 1 of 1
ONE CIVIC SQUARE MONICA HADDOCK
CARMEL, INDIANA 46032 C/O ese CHECK AMOUNT: $60.46
CHECK NUMBER: 227372
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 60 . 46 TRAVEL FEES & EXPENSE
DEC 10 2013
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.W)(1986)
Y MILEAGE CLAIM fob
(GOVERNMENTAL UNM
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF5- OARD,DEPARTi@rr OR 1N=-rUr10N)
p+��t, FROM TO SPEEDOMETER �(LpE,l�j�
D1�. POINT POINT I STAATEADING FINISH NATURE OF BUSINESS TRAAUTO VELED E ED P
-' -
L -- --- -
C
77 ci(o
AUTO LICENSE NO. TOTALS 10-17
+ 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 of the has been paid.
Date \ J� I+ it
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
1213/13 Reimb Mileage 11/20- 12/3/13 $ 60.46
Total $ 60.46
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$
$ 60.46
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
INVOICE NO. ACCT#/TITL AMOUNT
Dept#
1081-2 Reimb 4343000 $ 60.46 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
12-Dec 2013
1.
Signature
$ 60.46 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund