HomeMy WebLinkAbout243000 3 /11/2015 �/ CITY OF CARMEL, INDIANA VENDOR: 366990
ONE CIVIC SQUARE JOSH LANE CHECK AMOUNT: $********41.33*
;� ,�; CARMEL, INDIANA 46032 C/o ESE CHECK NUMBER: 243000
'-+;g;oN�• CHECK DATE: 03/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 41.33 TRAVEL FEES & EXPENSE
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PRESCRIBED SY STATE BOARD OF ACCOUNTS _ GMWU FORM NO.101 OUR
MILEAGE CLAIM
ON ACCOUNT OF APPROPRIATION NO FOR
(OFFICE,BOARD,DEPABTMENT OR NLMM ON)
DAT
FROM TO SRP OOMETER AUTO MILEAGE
POINT POINT START FINISH NATURE OF BUSINESS 1 E� ® -S4v <
PER MILE
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AUTO LICENSE NO. TOTALS �?j,g jr r 33
+ 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 195,Acts 1893,I hereby certify that the foregoing account is just and correct,that the amount claimed age due,after allowing all just credits.-
and
redits:
and that no part of the same has been paid.
Date Z!20 l S
2
TD
-� I
MAR 02
2�i5
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
2/20/15 Reimb Mileage 1/29-2/20/15
$ 41.33
Total $ 41.33
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.
366990 Lane, Josh Allowed 20
In Sum of$
$ 41.33 f
h
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT i Board Members
Dept#
1081-11 Reimb 4343000 $ 41.33 1 hereby certify that the attached invoice
i (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
.i
l
March 5, 2015
I
Signature
$ 41.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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