HomeMy WebLinkAbout236248 08/21/14 CITY OF CARMEL, INDIANA VENDOR: 080501
ONE CIVIC SQUARE CINDY SHEEKS
CHECK AMOUNT: $.."""`"'13.44•
;. ; CARMEL, INDIANA 46032 14382 WHISPER WIND DR CHECK NUMBER: 236248
CARMEL IN 46032 CHECK DATE: 08/21/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 13.44 DLGF MEETING
Prescribed by State Board of Accounts General Form No.101(1955)
MILEAGE CLAIM
� � l
A TO iL��lu- i DR.
(Gov 'r ental Unit) i.
On Account of Appropriation No. �I��J(� for
\(O ce,Board, De)Sartment or Institution)
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @ JlJ
20—L4 Point Point Start Finish TRAVELED PER MILE
i
j
I
Auto License No. TOTALS
I
* 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 legally due, after
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
c. That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently orrect
I $ '' ui c
iOn Account ofPP P �A ro nation No4oP4 for
,
—Ave,
l
j &�(Mse-s -
Disbursing Officer
�
N
Allowed 20 mCQ
¢ R.
! in the sum of$ o •
� (D
n N
N M
rE
moa
(Board or Commission) I ¢
I m m
j FILED o_ �1 4
1 cZ:r
� (D (
QD
V46 (Q�
�
Cn
(Official Title) ,
E O (D