HomeMy WebLinkAbout239075 11/11/14 CITY OF CARMEL, INDIANA VENDOR: 367837
1.
ONE CIVIC SQUARE MIKE MARTIN CHECKAMOUNT: $********31.02*
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CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 239075
*,troN�• CHECK DATE: 11/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 31.02 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS '/ GENERAL FORM 110.101(1980 ,
Cc �n MILEAGE CLAm
O l `1 q Sa
1 L 1
(GOVERNMENTAL UNn1
ON ACCOUNT OF APPROPRIATION NO. FOR
(01171C2,BOARD,DEP"TUDYT OR 1NSnTUTION)
FROM TO SPEEDOMETER
DATE READING } AUTO mII.EAGE
1 MATURE OF BUSINESS MILES. ® E
POINT POINT START FINISH TRAVELED PER
MILE
L b ®- \
--
AUTO LICENSE NO. TOTALS
+ 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 allow just credits,-
and that no part Of the same hasbeenpaid.
Date
( lam 1
ll� OCT z�
14
.rte�P•
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.
367837 Martin, Michael Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/22/14 Reimb Mileage 8/27- 10/20/14 $ 31.02
Total $ 31.02
I 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.
36783.7 Martin, Michael Allowed 20
In Sum of$
$ 31.02
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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PO#or INVOICE NO. ACCT#MTLE AMOUNT Board Members
Dept#
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1081-11 Reimb 4343000 $ 31.02 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
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' 6-Nov 2014
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Signature
$ 31.02 Accounts Payable Coordinator
Cost distribution ledger classification if i Title
claim paid motor vehicle highway fund
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