HomeMy WebLinkAbout232978 05/28/14 `'u s�q,,f CITY OF CARMEL, INDIANA VENDOR: 368251
V,
® t31 ONE CIVIC SQUARE CLAY ALLEN CHECK AMOUNT: $**'******8.96*
CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 232978
'�'/roii"�°'`9 CHECK DATE: 05/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 8.96 TRAVEL FEES & EXPENSE
p..:
r ,
PRESCRIBEDBY STATE BOARD OF ACCOURTO '��� OENF,RAL FOPM 110.!Ol(1BB6)
MILEAGE CLAoIMLs r�7
( NMENTAL UN1T1 ON ACCOUNT OF APPROPRIATION NO. FOR
I LOHME,BOARD,DEPARTMENT OR INSTITUTION)
i!t 2�DATE FROM TO SPEEDOMETER
.{L AUTOES
tDT$AC�E
PONT PONT START FINISH NATURE OF HUSINE56 TRAVELED ®r 4
PER MILE
i
I
AUTO LICENSE NO. TOTALS
k 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 y a lowing all just credits,,
and that no Apart of the same has been paid.
Date
�r M4Yd0
2' t +
1 ����
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be property itemized must show; kind of service, where performed, dates service rendered, by
j whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
j Allen, Clay Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bi(l(s)) PO# Amount
5/7/14 Reimb Mileage 4/15-4/17/14 $ 8.96
Total $ 8.96
I 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
0
, 2 _
Clerk-Treasurer
Voucher No. Warrant No.
Allen, Clay Allowed 20
In Sum of$
$ 8.96
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT i Board Members
Dept#
1081-10 Reimb 4343000 $ 8.96 j 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
22-May 2014
�
CA
Signature
$ 8.96 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund