HomeMy WebLinkAbout235378 07/30/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 065950
ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: $********35.28*
CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK NUMBER: 235378
CARMEL IN 46033-9501 CHECK DATE: 07/30/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 R4343004 26769 35.28 TRAVEL EXPENSES-NLC
HILTON PARKING GARAGE
120 W MARKET STREET
INDIANAPOLIS IN 46204
#014143 07/22/�014 2.15:47PM
01 CL.ERRO1 000000
llW 14.00 ',$14.00
DEPT-01
ITEMS 10
CAS14 `=- O
I C��
Prescribed by State Board of Accounts General Form No.101(1955)
PU
n MILEAGE CLAIM
01 � �
TO DR.
iL (GovernMental Unit)
On Account of Appropriation No. for
(Office,Board, Department or Institution)
DATE ,
/ FROM TO ODOMETER READING" NATURE OF BUSINESS AUTO MILES MILEAGE @�
20 ` Point Point Start Finish TRAVELED PER MILE
Z Zq
i
r
r
V
t�
7
I
i
I
Auto License No. TOTALS 11 7
* 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 claime is legally due, after
allowing all jug credits, and that no part of the same has been paid.
Date I'
I
i
} Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVO OF
That it is in proper form;
I That it is duly authenticated as required
41 by law;
Wal I" That it is based upon statutory authority,
l_ $ �l That it is apparently correct
ins ct
On Account of Appropriation No. �o�J for
f —7r?A 8( Disbursing Officer
CZ
Allowed 20 (D r o
Cr
in the sum of$ o -
Q
C) O 1�
En
r
m
N (p Q
00 ¢
(Board or Commission) ` O
� O
FILED m �
m
Q Q m
o
m
o
C) (D
dim
r�
(Officiad Title)
O
OEn -
0 (gD