HomeMy WebLinkAbout244302 4 /15/2015 y o!.F�qy
J�/ CITY OF CARMEL, INDIANA VENDOR: 368794
(;® ONE CIVIC SQUARE APRIL MURRAY CHECK AMOUNT: $********13.23*
:.. ,o CARMEL, INDIANA 46032 C/O LAW CHECK NUMBER: 244302
'+:,;ioN�. CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343004 13.23 TRAVEL PER DIEMS
I
Prescribed by State Board of Accounts I General Form No.101(1955)
MILEAGE CLAIM
City of Carmel, Indiana TO �'I I �,� I DR.
(Governmental Unit) F
Department of Law - 1180 On Account of Appropriation No. 434-30041 for Mileage.
Office,Board,Department or Institution) !
1.
C
DATE FROM TO ODOMETER READING" NATURE OF BUSINESS ` AUTO MILES MILEAGE
20 )5 Point Point Start Finish TRAVELED PER MILE
_ I
o s ' )-e v5 a- hocs W,,in Y&A' 413 i3 3
}
i
r
� II
r
I .
`I
I
Auto License•No, TOTALS 1IF01
*SPEEDOMETER READING columns are to be used.only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due after
allowing all just credits, and that no part of the same has been paid.
Date
L.
Clcdm No. Warrant No. I have examined the within claim and
f hereby certify as follows:
IN FAVOR OF �.
That it is in proper form;
t That it is duly authenticated as required
by law;
i
y;. That it is based upon statutory authority;
That it is apparently correct
23 L incorrect
On Account of Appropriction No.4343004 for l
k
Disbursing Officer
Department of Law - 1180
� (D
Allowed 20 mR.
O o
in the sum of$ o "
m
c ((D
4
(D ¢
o g�
N (D0 FJ-
i)
rt
(Board or Commission) ; ¢ S
rt
FILED ° (D ¢j
B
c cD
n (D
m
'
(OD
i N
En (D
� ccn
(Officica Title) ,
I
0