HomeMy WebLinkAbout240144 12/09/14 4%''�'�F• CITY OF CARMEL, INDIANA VENDOR: 366471
® ONE CIVIC SQUARE SHANDI WALKER CHECK AMOUNT: $*******166.88*
CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 240144
`''icTON CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 166.88 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENUAL FORM 110.101(1985)
MILEAGE CLAIM ���
TO
(GOVERNMENTAL WM ON ACCOUNT OF APPROPRIATION NO. FOR
(OF-M14 BOARD,DEP.ARTD¢](r OR TNS=109)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING t MILES, p
POINT POINT START FINISH
NATURE'OF BUSINESS TRAVELED
PER MILE..
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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. `tea
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 d e fter aliowingall-Just credits;
and that no part of the same has been paid.
Date
SooDEC - 22014 �
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.101(1986)
n MILEAGE CLAIM
TO �SNk
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO_ � FOR
(OFFICE,HOARD,DEPARTMENT OR 1NSnTUnONJ
SPEEDOMETER
DATE FROM TOREADING + NAT[TRE"OF BUSINESS AMILES QeE5f0
28_ POINT POINT START FINISH i TRAVELED PER MILE
yym
Cl q
f_
C.
e
a
� a
pa
AUTO LICENSE NO. TOTALS '11 a 3 j
+ 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, alioyving all just credits:
end that no part of the same has been paid.
Date �J v
DEC - 2 2014
Com/
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.
366471 Walker, Shandi Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
11/26/14 Reimb Mileage 11/10- 11/26/14 $ 166.88
Total $ 166.88
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.
366471 Walker, Shandi I Allowed 20
i
i In Sum of$
$ 166.88
ON ACCOUNT OF APPROPRIATION FOR
j 108 -ESE
i
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-9 Reimb 4343000 $ 166.88 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
3-Dec 2014
Signature
$ 166.88 Accounts Payable Coordinator
Cost distribution ledger classification if Title
i
claim paid motor vehicle highway fund