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242034 2 /10/2015 0''" CITY OF CARMEL, INDIANA VENDOR: 366990 ® 4� �• ONE CIVIC SQUARE JOSH LANE CHECK AMOUNT: $"'*****59.02* s ?� CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 242034 9M�roN..�.` CHECK DATE: 02/10/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 59.02 TRAVEL FEES & EXPENSE f I t GENERAL FOAM 110.101 U995) PRESCRIBED BY STATE BOARD OT ACCOUN75 MILEAGE CLAIMTO- (GOVERNMENTAL UNITI I ON ACCOUNT OF APPROPRIATION NO_ FOR i (OFFICE,BOARD.DEPARTTMU OR INSTITUTION) FROM TO SPEEDOMETER AUTO E HEADING + NATURE OF BUSINESS MILES p DATE TRAVELED POINT POINT STAHPER7:� FINISH MILE _c_ W M k 31, D R�'-G NitGG r- a- [3yc�G C Latif S l`ps �'� 3.0 o w b .ti c t°2s '3-0 tr71S�- ! AC Ld` egcc dL cs �O.o L tok W rt LGL 6..tX Lk r&. r4..•.. t7 kL �A WB 1ta LOLL d �.r�lG (;C *-g µ,GQ Gu6r., !2t ' u It �.rf3 C C d goo /art V Op /u CC e a - .o a MaC- Adpkw-�1a wi3 rct� l tl G.r} zI c.13 SLG .es '3, rp.t s %.J ia•.C� .p C M144 AUTO LICENSE NO- TOTALSS( OZ + 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 ani correct,that the amount claimed is legally due after aliowing all just cr and that no part of the same has been paid. lI Date 2�,( fS © j ; ��� `--1 Jim Z ..• �A .-c I FEB -3 2015 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. 366990 Lane, Josh Terms Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1/27/15 Reimb Mileage 12/8/14- 1/27/15 $ 59.02 Total $ 59.02 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 i i Voucher No. Warrant No. 366990 Lane, Josh Allowed 20 In Sum of$ $ 59.02 ON ACCOUNT OF APPROPRIATION FOR 108 -ESE , 1 PO#or Board Members INVOICE NO. AccT#/TITLE AMOUNT ! Dept# i 1081-11 Reimb 4343000 $ 59.02 1 hereby certify that the attached invoice(s), or I bill(s)is(are)true and correct and that the f materials or services itemized thereon for I which charge is made were ordered and received except ,I y I' I February 5, 2015 I i Signature $ 59.02._ f Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund