HomeMy WebLinkAbout243060 03/11/15 CITY OF CARMEL, INDIANA VENDOR: 369165
z® 1 ONE CIVIC SQUARE KIEFER SUMMERS CHECK AMOUNT: $********18.04*
9 �=a CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 243060
�.,�oN-�` CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 18.04 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(10116)
MILEAGE CLAIM (' s C C ce Q
TO____ l 1 ,\
(GOVERNMENTAL TWIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
IOF CE,BOARD,DEPARTMENT OR INSTTMTTION)
DATE FROM TO SPEEDOMETER AUTO MIL AGE
REATJWG { NATUREOFBUSINESS MILES 0 _ E
- POINT POINT START FINISH TRAVELED PER MILE
C q L A ra S e �;h t FiY" 4- 4.1hoal r
oaf- . uJes+ r r
MADA e {-as M r 4
E; bveh� �j,�Y M Ge ar 1 q y
_
2 e Neht•Y LtcLre r +M F-et- F v frFrr-eh �.Se � ;L' S1108
8 . 00+
6 . 50 +
8 . 00 +
9 . 80+
32 . 30
32 . 30x
0 . 56=
18 . 09
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, U (f J
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,
and that no part of the same has been paid. ,
Date Z&-'//4Sl
q5vo
L AR 03
y�ly
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.
Summers, Kiefer Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
2/24/15 Reimb Mileage 2/5-2/23/15 $ 18.04
Total $ 18.04
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
I
Voucher No. Warrant No. t
Summers, Kiefer Allowed 20
IIjIn Sum of$
1.
$ 18.041.
l
ON ACCOUNT OF APPROPRIATION FOR 4
108 -ESE
i
I�
PO#or INVOICE NO. ACCT#/TITLE AMOUNT I Board Members
Dept#
1081-10 Reimb 4343000 $ 18.04. 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
i March 5, 2015
11P.
I Signature
$ 18.04 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I