HomeMy WebLinkAbout244946 05/05/2015 %'G,�v CITY OF CARMEL, INDIANA VENDOR: 362732 *
ONE CIVIC SQUARE PAMELA LISTER CHECK AMOUNT: $********64.32
s. Q CARMEL, INDIANA 46032 11598 MANSFIELD PLACE CHECK NUMBER: 244946
,,y.____, CARMEL IN 48032 CHECK DATE: 05/05/15
«ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 64.32 TRAVEL PER DIEMS
2rescrl69dby8iateBoard ofAccormts MILEAGE CLAIM �
Genera!Form No, 101(1 955)
TO
(Govern— men aUnit)
On Account of Appropriation No. 436
OFilce,Boar ,Department or ns tutlon)
for
FROM TO ODOMETER READING* AUTO MILES MILEAGE _
DATE NATURE OF BUSINESS
Point Point Start Finish
20 -� 6� 1 TRAVELEDPER MILE
. !�
i G0 � 1 3
IA
1A 19 14
�t Ut k
IA
w ` nS'S o tti >n a
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Auto"License No. TOTALS
* SPEEDOMETER READING columns-are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155;Acts 1953, 1-hereby-certify that the foregoing account is just and correct,that the amount cla' ed is legal. due,a r
allowing all just credits, and that no part
Joff the same has been paid.
�I
Clcdm No. Warrant No. I have exc¢nined the witivn claim chid
hereby Certify as follows;
IN FAVOR OF
That'it is in proper form;
That it is duly authenticated as requt
- , . . .�. by law;
That it is based upon statutory author
[�T, That it is apparentCorrect
ly
ii-1correct
O Account
n t of No. for .
Disbursing Officer
� 1 O
.. .. _ Allowed ,20` N
ty
In the sum of$
(Board or Commission) �� W
FILED
(olficial Title)
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