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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-- ro i (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 L� POINT POINT START FINISH TRAVELED PER MILE JQ t t-z' OS sal .e Ap �v D 00-7S 5 t�F 6" — . fc.. U —_ -, 7 01-Tn S lam' 1. ob ) f) f�s�ati ,rte ;rtes-�c+� —,GQ—. rnV 10 I 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