HomeMy WebLinkAbout236781 09/10/14 CITY OF CARMEL, INDIANA VENDOR: 368615
ONE CIVIC SQUARE ANDRE BROADNAX CHECK AMOUNT: $*********4.48*
?� CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 236781
9M��uri ' CHECK DATE: 09/10/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 4.48 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL;ORM 110-JO)11986)
C cp�' MILEAGE CL
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO, FOR
(Oy-1-73E'BEARD,DEPARTItEHT OR INSTITUTION)
FROM TO -SPEEDOMETER AUTO MILEAGE
READING + NATURE OF BUSINESS MILES a SO C
POINT TRAVELED
POINT START FINISH PER MILE
-7-
AUTO LICENSE NO. TOTALS 19 mq IRI
+ 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 legal;y due,a allowing g1l just credits
end that no part of he same has been paid.
Date q"
SEP 2 ',A
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
Broadnax, Andre Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/21/14 Reimb Mileage 8/29/14 $ 4.48
Total $ 4.48
1 hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20_
Clerk-Treasurer
Voucher No. Warrant No.
Broadnax, Andre Allowed 20
In Sum of$
$ 4.48
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members
Deptept#
1081-10 Reimb 4343000 $ 4.48 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
4-Sep 2014
Signature
$ 4.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund