HomeMy WebLinkAbout249349 09/09/15 .GAA .
`�' `' CITY OF CARMEL, INDIANA VENDOR: 362732
® `tl ONE CIVIC SQUARE PAMELA LISTER CHECK AMOUNT: $ .....'74.67`
CARMEL, INDIANA 46032 11598 MANSFIELD PLACE CHECK NUMBER: 249349
�'";�.�N�.? CARMEL IN 46032 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 MILEAGE 74.67 TRAVEL PER DIEMS
ueneral Form No. 101 (1855)
eacdbed by
SOW Board or Accounts MILEAGE CLAIM
TOC
'Ylovemmenta n
On Account of Appropriation No. for
� r ape �for ns lu on --"--
/ ce,
TO ODOMETER READING" NATURE OF BUSINESS TO MILES MILEAGE @
DATE FROM Start Finish TRAVELED PER MILE /ot
Point
Point � � 5� 3`� � �
20
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6L 0 D
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co 13 3 S
$7 7'1 'Iq 660 -
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TOTALS G 7
Aulo License No.
NG columns are to be used only when distance between points cannot be determined by fixed mileage or officiala amount me a all due a er
SPEEy rnap.
DOMETER READING that the foregoing account is just and correct,that h gaily
Pursuant to the provisions and penalties of Chapter 155,Acts 1953, 1 hereby certify
all use credits, and that no part of the same has been paid.
allowing j
Claim No. Warrant No.----- I have examined the within ckdun,and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
PPHI ( i I-t'r e– — That it is duly authenticated ccs requi
by 1aw;
That it is based upon statutory author
That it is apparently j Correct
l incorrect
On Account of Appropriation No.-1-13K-641 for
Disbursing 01fimr
Allowed ,20
in the sum of$
V, 'M
N c�D
I(Iiccad of Commissbn)
FILED
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(Olflclul TIUe)
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