HomeMy WebLinkAbout231192 04/08/14 a` �,»,F. CITY OF CARMEL, INDIANA VENDOR: 368109
® ONE CIVIC SQUARE OLIVIA CHANCE CHECK AMOUNT: $********42.34*
?� CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 231 192
�M'<ioN co CHECK DATE: 04/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 42.34 TRAVEL FEES & EXPENSE
PRESCRIBED By STATE BOARD OF ACCOUNTS
GENERAL FORM NO.101(1986)
G MILEAGE CLAIM
TO
(GOVERNM AL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR INSTITUTION)
DATE, FROM _ TO READ NG a AUTO MILEAGE
POINTPONT START FINISH NATURE OF BUSINESS MILES ®
TRAVELED PER MILE
ZO LC—L oI f0 S.+ SC A 0 �y
CoMi&LA bac -/o own S co kz
o r fo Su Sc�oo !bown.d6wok S Li -Ion �v ¢/s a
11 s rtt K) rw o bcck No ,/4. 23. 2
k- Mono n fu S
cu Mona+n er Wo IC i n" 8.
Li
no Mae, z6 11
rpo /CR+ /t� b✓ .60
/t�t� o o ,-po a yrs auv 1 (o
J 11
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 legall d e,after allowing all just credits
and 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.
Chance, Olivia Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/25/14 Reimb Mileage 1/28 - 3/25/14 $ 42.34
Total $ 42.34
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.
Chance, Olivia Allowed 20
In Sum of$
$ 42.34
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept# INVOICE NO. CCT#/TITLjAMOUNT1081-11 Reimb 4343000 42.34 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
3-Apr 2014
Signature
$ 42.34 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund