234336 07/01/14 Q
CITY OF CARMEL, INDIANA VENDOR: 362732
ONE CIVIC SQUARE PAMELA LISTER CHECK AMOUNT: S********89.60CARMEL, INDIANA 46032 11598 MANSFIELD PLACE CHECK NUMBER: 234336
CARMEL IN 46032 CHECK DATE: 07/01/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 89.60 TRAVEL PER DIEMS
1 General form No. 101(1 X55)
C0_A0M
I have examined the within cicdixi cmd
hereby certify as follows: TO KOr.' SP D R.
That-it is in proper form; On Account of Appropriation No. 4,36 _aT for.m"
That it is duly authenticated as requi
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That it-is-based-upon statutory author :TER READING` NATURE OF BUSINESS AUTO MILES MILEAGE @
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Finish TRAVELED PER MILE
- That,it is apparcorrect
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letermined by fixed mileage or official highway map.
account is just and correct,that the amount claimed is legally due,after
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Claim No. Warrant No.
IN FAVOR OF
r
` On Account of Appropriation No.. -64 foi
Allowed 20
in the sum of$
(Board or commission)
FILED
(Official Title)