HomeMy WebLinkAbout235429 07/30/14 �/ �� CITY OF CARMEL, INDIANA VENDOR: 00353131
ONE CIVIC SQUARE SANDY JOHNSON
" CHECK AMOUNT: $*******"24.64•
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:C ,?� CARMEL, INDIANA 46032 C/O CLERK-TREASURER'S OFFICE CHECK NUMBER: 235429
9M�li0N�� CARMEL IN 46032 CHECK DATE: 07/30/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 24.64 TRAVEL PER DIEMS
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Prescribed by State Board of Accounts ,MILEAGE CLAIM General Form No.101 (1955)
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TO DR.
(Governmental Unit)
C L-e-,r V-- 1 rj?- _C,( re—c— On Account of Appropriation No. for
(Office,Board,Department or Institution)
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS I AUTO MILES MILEAGE
20 y Point Point RStart Finish TRAVELED PER MILE
I —{ A CUv �n Ud 40(o C-Ck
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v 0 2 So (o v I I
Auto License No. TOTALS (p
* SPEEDOMETER READING columns are to belused only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, a
allowing all just credits, and that no part of the same has been paid.
Date
I '
Clam No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
correct
That it is apparently {incorrect
O c ount of Appr priation No. for
law
d Disbursing Officer
JJJ 4 IN�
I Allowed ,20 1 t o
in the sum of$
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