HomeMy WebLinkAbout230513 03/26/14 �_Coq
'' CITY OF CARMEL, INDIANA VENDOR: 366990
® i'r ONE CIVIC SQUARE JOSH LANE CHECK AMOUNT: $***.....59.70*
x. CARMEL, INDIANA 46032 CIO ESE CHECK NUMBER: 230513
'�;_roN.�' CHECK DATE: 03/26/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 59.70 TRAVEL FEES & EXPENSE
I
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101 11996
MILEAGE CLAIM /� ,
L L 1 �� TO J JS
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRL4TION NO. FOR
(OFFICE,BOARD.DEPARTMENT oR INSTITUTION)
SPEEDOMETER
�Iyp'a FROM TOREADING I• AUTO MILEAGE
�L NATURE OF$USINESS MILES ®- ¢
POINT 1 11 POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS t 0(� 5 9. 7D
+ 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 legal due,after allowinga us credits
end that no part of the same has been paid.
Date 3�1211 N
�- Nn
MAR 17 2014
BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bili 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
3/17/14 Reimb Mileage 2/19 - 3/13/14 $ 59.70
Total $ 59.70
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.
366990 Lane, Josh Allowed 20
In Sum of$
$ 59.70
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept#
1081-11 Reimb 4343000 $ 59.70 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
20-Mar 2014
2 01
Signature
$ 59.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund