HomeMy WebLinkAbout244196 4 /15/2015 9, "p'' CITY OF CARMEL, INDIANA VENDOR: 358408
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: 5..""'133.98•
INDIANAPOLIS;?q CARMEL, INDIANA 46032 5057 E 71 ST STREET CHECK NUMBER: 244196
�'��roe�°' INDIANAPOLIS IN 46205 CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 133.98 TRAVEL FEES & EXPENSE
PRESCRIBED BY SrATt BOARD OF ACCOUNTS GENUAL FORM NO.101(1906)
MILEAGE CLAIM
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(GOVEMMENTAL UNIT) _
7�_ S ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE,BOARD.DETARTW:EKr OR 1NSr=1OH)
FROM TO SPEEDOMETER _
READING + AUTO E
28 I POINT POINT START FINISH NATURE OF BUSINESS Cdr
TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS 'amp
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway.map. 33 1 33, _IS
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 aliowin,g_all just credits;
and that no part of the same has been paid.
Date L�
60
V
APR 01 2015
�YN
ACCOUNTS PAYABLE VO'U'CHER
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`.
358408 Buckingham, Tiffany Terms
5057 E 71 St St
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) P0# Amount
3/27/15 Reimb. Mileage 1/27-3/27/15 $ 133.98
Total $ 133.98-
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.
358408 Buckingham, Tiffany Allowed 20
5057 E 71 st St
Indianapolis, IN 46205 t
In Sum of.$
$ 133.98
ON ACCOUNT OF APPROPRIATION FOR
I
108 -ESE
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1081-2 Reimb. 4343000 $ 133.98 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
April 9, 2015
'P
Signature
$ 133.98 Accounts Payable.Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund