HomeMy WebLinkAbout240622 01/07/2015 +ur.C4NM
;`." CITY OF CARMEL, INDIANA VENDOR: 363096
;; b it ONE CIVIC SQUARE MICK BARTON CHECK AMOUNT: S**"""**106.40"
;' i
CARMEL, INDIANA 46032 CHECK NUMBER: 240622
"�t>aN a�' CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 106.40 TRAVEL FEES & EXPENSE
FDEC 2 9 2014
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_ gar-E-br
PRESCRIM BY STATL 80ARD OF ACCOUNTS GENERAL FORM 110.101(1964)
_ �/ ✓ MILEAGE CLAIM M i�'
(GOVFANNENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
COMM BOARD.DEPARTMENT OR INSMUT108)
D1�T$ FROM TO SIDING + AUTO MILE E
�tL�1— NATURE OF BUSINESS MILES @_ c
POINT POINT START FINISH TRAVELED PER SLE
MCA Qn - ; - 11 LA- t
Lo qwe G 0G 8 u
Q j VbC
d wG _—.— pt $ o a Vz 5 10 L( Li
WC 614 0
to -- � > i
J1 t3�?1� -1,
-- _ _ 00 $60 t 1
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if 00 LIN mL '."q 4 _ '7'q Lv7
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AUTO LICENSE NO. TOTALS 10 -�O
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 16,o
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 Olowing all i t ere 'ls
and that no part of the same has been paid.
Date
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.
363096 Barton, Mick Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/18/14 Reimb Mileage 9/30- 12/18/14 $ 106.40
�I
Total $ 106.40
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
120
Clerk-Treasurer
Voucher No. Warrant No.
363096 Barton, Mick Allowed 20
4 In Sum of$
$ 106.40
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-10 Reimb 4343000 $ 106.40 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
2-Jan 2015
Signature
$ 106.40 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund