HomeMy WebLinkAbout244173 04/15/15 �Y tf. CITY OF CARMEL, INDIANA VENDOR: 00350221
it ONE CIVIC SQUARE LINDA ACOSTA CHECK AMOUNT: $********25.85*
?� CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 244173
F.y�roN..`q,� CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 25.85 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101 EMS)
j� MILEAGE CLAIM 1»CSC- C\cu :JN--
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(GOVFANMENrAL TWIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE,BOARD,DEPART'IMG OB INST[TUTION)
SPEEDOMETER AUTO MILEAGE
DA,TE FROM TO READING + NATURE OF BUSINESS 11 MILES @"5l•J E
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POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS 45 S ��
+ 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 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,aer allowing just credits:
and that no part of the same has been paid.
Date
APR 0 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.:
00350221 Acosta, Linda Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/20/15 Reimb. Mileage 1/26- 3/20/15_ $ 25.85
Total, $ 25.85
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
Voucher No. Warrant No. . .
00350221, Acosta,Linda Allowed 20
In Sum of_$
25.85
ON ACCOUNT OF APPROPRIATION FOR {'
108`-ESE
Po#or Board Members
INVOICE No. ACCT#/TITLE AMOUNT -
Dept#
1081-99 Reimb... : _ 4343000•._ $" 25.85;_ I I hereby certify that the attached invoice(s), or
_. - _. a e
bill(s).is(are)true and correct and that th
{: materials or services itemized thereon for
I which charge is made were ordered and
received except
t -
April 9,.2015
Signature
5.85 . Accountspayable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund