HomeMy WebLinkAbout244956 05/05/15 `' c,q,,�� CITY OF CARMEL, INDIANA VENDOR: 368794
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'I• ONE CIVIC SQUARE APRIL MURRAY CHECK AMOUNT: $""'""25.81"
s ,_� CARMEL, INDIANA 46032 C/O LAW CHECK NUMBER: 244956
981//�oN�. CHECK DATE: 05/05/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343004 25.81 TRAVEL PER DIEMS
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Pfescribed by State Board of Accounts General Form No.101(1955)
MILEAGE CLAIM
City of Carmel, Indiana TO ffiQY-r6L\J DR.
(Governmental Unit)
Department of Law - 1180 ' �' On Account of Appropriation No. 434-3004 for Mileage•
Office,Board,Department or Institution)
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DATE FROM TO ODOMETER READING* NATURE OF BUSINESS i AUTO MILES MILEAGE @ J�Zt, 5
20 Point Point Start Finish TRAVELED PER MILE
4/1144 5 ("a a r t 1l _ 3- o�
,qM 16 4 r&t 1 Na s 1,95 V; l Q /w1, 1403 f qZq j� l- IW 12-M E-0 I 2 d
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Auto License No: TOTALS ! 5
* SPEEDOMETER READING columns are to be used only when distance between points cannot be determined.by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally duq, after
allowing all just credits, and that no part of the same has been paid.
Date
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Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
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That it is duly authenticated as required
by law;
That it is based upon statutory authority;
r• cJ ,� � That it is apparently {inco ect
On Account of Appropriation No.4343004 for
Disbursing Officer
Department of Law - 1180
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in the sum of$ o r- n
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