HomeMy WebLinkAbout232454 05/13/14 `/�c�A� CITY OF CARMEL, INDIANA VENDOR: 358408
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $*******142.80*
�_�, CARMEL, INDIANA 46032 5057 E 71ST STREET CHECK NUMBER: 232454
"'''ETON�` INDIANAPOLIS IN 46205 CHECK DATE: 05/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 142.80 TRAVEL FEES & EXPENSE
GFNFAAL FORM 110.101(1986)
PRFSCRIEED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM 1 1 ��y ` V 1 a
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FROM p0 — SPEEDOMETER AUTO MILEAGE
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POINT POINT START FINISH TRAVELED PER MILE
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+ 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 ega ly due,after allowing all just credits,
end that no part of the same has been paid.
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Date
/1'�JrV111 S`\/ ,Tl\ � -�^. �Ems`'Fi l.`4' i..C'.,�-_•:..�?3
f �V,-
MAY 0 12014
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.
358408 Buckingham, Tiffany Terms
5057 E 71st St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/24/14 . Reimb. Mileage 3/5,- 4/23/14 $ 142.80
Total $ 142.80
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.
358408 Buckingham, Tiffany l Allowed 20
5057 E 71st St
Indianapolis, IN 46205
In Sum of$
$ 142.80
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ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members
Dept#
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1081-2 Reimb. 4343000 $ 142.80 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
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8-May 2014
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Signature
$ 142.80 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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