HomeMy WebLinkAbout231478 04/16/14 o
CITY OF CARMEL, INDIANA VENDOR: 065950
ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: $******"*47.60'CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK NUMBER: 231478
CARMEL IN 46033-9501 CHECK DATE: 04/16/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 19.60 MILEAGE
1701 4343004 28.00 PARKING
HILTON PARRING GARAGE
120 W MARKET STREET
INDIANAPOLIS IN 46204
#010968 04/14/2014 3:48:39PM
01 CLERKOI 000000
1@ 28.00 T1$28.00
DEPT-01
ITEMS 10
CASH $28. 00
Prescribed by State Board of Accounts General Form No.101 (1955)
C
MILEAGE CLAIM
��� TO (�630 DR.
(Governmental Unit)
Cen' Vt'rA-53 U r E On Account of Appropriation No. '/U for
(Office,Board, Department or Instituti n)
DATE FROM TO ODOMETER READING` NATURE OF BUSINESS AUTO MILES MILEAGE @ i
20 Point Point Start Finish TRAVI,L PER MILE
(�
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally, du e, after
allowing all just credits, and that no part of the same has been paid. `
Date � / �e--
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
I FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
Cv That it is based upon statutory authority;
That it is apparently cor�rrect
$
-�On Account of Appropriation No. for
Disbursing Officer
Allowed 20 (D ¢
a 0 ,
in the sum of $
(D
(D
Q
m
CD " 9
a
(Board or Commission)
(D
FILED (D
O N
O
QD
(OD U' (�D
" ( D
(D (D
(Official Title) D
O "
ON ¢