HomeMy WebLinkAbout230017 03/12/14 u.Cqq*
CITY OF CARMEL, INDIANA VENDOR: 366990
ONE CIVIC SQUARE JOSH LANE CHECK AMOUNT: $ ....*"46.09"
CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 230017
'M�roii co;t. CHECK DATE: 03/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 46.09 TRAVEL FEES & EXPENSE
7FEB
21i 2014
PRESCRIBED BY STATE HOARD OF ACCOUNTS --.— -- . - 1 '
1 GENERAL FORM NO.101.119867
MILEAGE'CLAIM
CGP iZ TO �5
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,HOARD,DEPARTMENT OR DISnTUTION)
DAT FROM TO SPEEDOMETER AUTO MILEAGE
READING + NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED E Seo a
PER MILE
To,- T4/Vb S/eLvE occstE ✓
3 �Ze 'draw ✓ [. 2
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AUTO LICENSE NO. TOTALS !1-Qi /
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. z 3 q( 09/
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 after allowing all ' credits
end that no part of the same has been paid.
Date
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.
366990 Lane, Josh Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
2/18/14 Reimb Mileage 1/3 - 2/18/14 $ 46.09
Total $ 46.09
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.
366990 Lane, Josh Allowed 20
i
In Sum of$
i
$ 46.09
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
INVOICE NO. ACCT#/T1TLE AMOUNT
Dept#
1081-11 Reimb 4343000 $ 46.09 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
6-Mar 2014
Signature
$ 46.09 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund