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HomeMy WebLinkAbout231575 04/23/14 CITY OF CARMEL, INDIANA VENDOR: 363096
a,
ONE CIVIC SQUARE MICK BARTON CHECK AMOUNT: $**......67.52*CARMEL, INDIANA 46032 CHECK NUMBER: 231 575
CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIM 67.52 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(IM)
MILEAGE CLAIM ©�C)
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(GOVEANNENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
t tdF710E,BOARD,DEPARTMENT OR INST[TUTION7
SPEEDOMETER
Iy E I FROM TO POINT 11 READING + NATURE OF BUSINES6 AMILES @
UTO E
z� � POINT START FINISH TRAVELED PEAER MILE M (a
ILE
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AUTO LICENSE NO, TOTALS 01 / . 7
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
ALJ
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 jus credits
end that no part of the same has been paid:
Date (71
r
J�o 0y,
0 � [
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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.
363096 Barton, Mick Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
4/3/14 Reimb Mileage 5/29/13 - 4/3/14 $ 67.52
I
Total $ 67.52
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.
363096 Barton, Mick Allowed 20
In Sum of$
$ 67.52
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-10 Reimb 4343000 $ 67.52 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
17-Apr 2014
Signature
$ 67.52 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund