HomeMy WebLinkAbout238055 10/15/14 CITY OF CARMEL, INDIANA VENDOR: 358408
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
`/ ��. CHECK AMOUNT: $"""""144.48'
i9, _�; CARMEL, INDIANA 46032 5057 E 71 ST STREET CHECK NUMBER: 238055
biiroN-co' INDIANAPOLIS IN 46205 CHECK DATE: 10/15/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 144.48 TRAVEL FEES & EXPENSE
PRESCRIBED 8Y STATE BOARD OF ACCOUNTS Jam. i GENERAL FORA 110.101 11986)
MILEAGE CLAIM ` ka
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(GOVERNMENTAL UNM ON ACCOUNT OF APPROPRIATION O. FOA
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(Oii10E,BOARD.DEPART1R7fT OA lNSTOU'TiON)
DATE FROM TO SPEEDOMETER
READING + AUTO MILEAGE
-1-= POINT POINT START FINISH MATURE OF BUSINESS TRAVELED —
_ PER MILE
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AUTO LICENSE NO. TOTALS
t 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 le y due,after al owing all just credits.
and that no part of th^-e�saymye�has been paid.
Date
i
3 J
SEP 13 2014
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.
358408 Buckingham, Tiffany Terms
5057 E 71 st St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO-* Amount
9/17/14 Reimb. Mileage 7/24- 9/16/14 $ 144.48
Total $ 144.48
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. j
358408 Buckingham, Tiffany Allowed 20'
5057E 71st St
Indianapolis, IN 46205 I
I In Sum of$
I
$ 144.48
k
ON ACCOUNT OF APPROPRIATION FOR
I
108 -ESE
I
PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members
Dept#
1081-2 Reimb. 4343000 $ 144.48 1 hereby certify that the attached invoice(s), or
bill(s) is(are)truer and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
9-Oct 2014
Signature
1
$ 144.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund