HomeMy WebLinkAbout235611 08/06/14 CITY OF CARMEL, INDIANA VENDOR: 362732
® ONE CIVIC SQUARE PAMELA LISTER CHECK AMOUNT: $********66.64*
CARMEL, INDIANA 46032 11598 MANSFIELD PLACE CHECK NUMBER: 235611
CARMEL IN 46032 CHECK DATE: 08/06/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 66.64 TRAVEL PER DIEMS
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General Form No,101(I D55)
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On Account of Appropriation No. tr3din.,
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oaepa Ment or Instilut on for
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DATE ODOMETER READING* i
NATURE OF BUSINESS ti AUTO MILES MILEAGE
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" � ;: Point Point Start Finish f ,od TRAVELED PER MILE
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Auto License No. TOTALS
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* SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,:1 hereby certify that the foregoing account is just and correct,that the amount claimed is le ally due,a r
allowing all just credits,and that no part of the some has been paid.
i
Claim No. Warrant No,- I have examined the within cicdin and
- hereby certify as follows:
IN FAVOR OF
i That it is in proper form;
my authenticated as regal
- ;That itisd
aw;
- That it is- aced upon statutory au o:
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correct
Y; incorrect
That it' ap
On Recount of Appropriation No, L for. ..
" Disbursing Officer
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. Allowed
in the sum of$
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(Bowd or Commission) 19
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