HomeMy WebLinkAbout238046 10/15/14 a"!•c'�gb
CITY OF CARMEL, INDIANA VENDOR: 364750
ONE CIVIC SQUARE JESSICA BALLINGER CHECK AMOUNT: $*******1 16.48*
CARMEL, INDIANA 46032 10830 TOOLEY CT CHECK NUMBER: 238046
9Ml9oiiAPT IF CHECK DATE: 10/15/14
INDIANAPOLIS IN 46234
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 116.48 TRAVEL FEES & EXPENSE
P`
I
I
i
PRESCRIBED MY STATS BOARD OF ACCOUNTS GENERAL FORM 170.101(1996)
MILEAGE CLAIM
d,(I?
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
[OFi10E,BOARD,DEPARTMENT OR iNSUTUT10N)
f DAT FROM TO BREADING TER AUTO MILEAGE
2d + NATURE OF BUSINESS MILES ® ' !Ste e
POINT POINT START FINISH TAAVELED PER MILE
_ Gn
YONCiri
20 _
Z
22
j 2 _
2
2
3 �
y
1 --
1
11 19 11 L4 I t4s
11 Ts 11 Q 19tV
9 11 14 149
11' 44 Iq9
11 LF
- - -
2
2
NV K Jill
AUTO LICENSE NO. TOTALS
�5
+ 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,I hereby certify that the foregoing account.is just and correct,that-the amount claimed is legally due,after allowing all just credits
and that nopart of the same has been paid.
/
Date LO 1.3 l"I vH/
� f
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.
364750 Ballinger, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/3/14 Reimb Mileage 8/13- 10/1/14 $ 116.48
Total $ 116.48
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
f
II
Voucher No. Warrant No.
364750 Ballinger, Jessica Allowed 20
In Sum of$
I
i
$ 116.48
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Board Members
pOpt#IINVOICE NO. CCT#/TITL AMOUNT
I
1081-10 Reimb 4343000 $ 116.48 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
9-Oct 2014
Signature
$ 116.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund