HomeMy WebLinkAbout239919 12/09/2014 i Coq
CITY OF CARMEL, INDIANA VENDOR: 358408
d it ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $*******147.84*
�_ ;=Q CARMEL, INDIANA 46032 5057 E 71ST STREET CHECK NUMBER: 239919
?y,_�H.�o. INDIANAPOLIS IN 46205 CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 147.84 TRAVEL FEES & EXPENSE
GENERAL FORM NO.10)11986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS --T 1
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MILEAGE CLAIM j '
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(DOVER NENTALU�NNI-T)y../� ON ACCOUNT OF APPROPRIATION NO. FOR
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10F icE,BOARD,DEPAATwo;T OR INST ruvom)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING + NATURE OF BUSINESS TRAVELEDI a� ,
Zo POINT POINT START FINISHPER MILE
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AUTO LICENSENO. 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 allowing all just credits
end that no part of the same has been paid.
7
Date VV VV'
o J
NOV-------------
24 2014
BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized rate must
show',
kind of service,
here perperform de dates service rendered, by
whom, rates per day, number of hours.
Payee Purchase Order No.
Terms
358408 Buckingham, Tiffany
5057 E 71 st St
Indianapolis, IN 46205
Invoice Invoice Description PO# [;Amount
Date Number (or note attached invoice(s)or bill(s)) 147.84
11/10/14 Reimb. Mileage 9/17 - 11/10/14
Total $ 147.84
oice(s),or bill(s)is(are)true and correct and I have audited same in accordance
I hereby certify that the attached inv
with IC 5-11-10-1.6
20
Clerk-Treasurer
Voucher No. Warrant No.
358408 Buckingham, Tiffany Allowed 20
5057 E 71st St
Indianapolis, IN 46205
In Sum of$
$ 147.84
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-2 Reimb. 4343000 $ 147.84 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
r
3-Dec 2014
Signature
$ 147.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund