HomeMy WebLinkAbout249673 09/23/15 Cqq
CITY OF CARMEL, INDIANA VENDOR: 369012
ONE CIVIC SQUARE ANTHONY ENGLAND CHECK AMOUNT: $******—25.53'
25.53*
4 CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 249673
;oN CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 25.53 TRAVEL FEES & EXPENSE
SEP 0 2015
PRESCRIBED BY STATE BOARD OF ACCOUNTS ---.__.._ __ GENERAL FORD TIO.101(1906)
MILEAGE CLAIM
An laCny Eng/and
(GOVERNMENTAL MIT) TO
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR TNSTMITION)
SF WD + (1G
DATE FROM TO READING
AUTO MILE I J
2D /.S _ NATURE OF BUSINESS MILES p
POINT POINT START FINISH TRAVELED PEA MILE
--Z
-:- Sr+.-KPy Rosy W?Sf (/Ay �. Z 2.3,5"
3 /U W7Sf (/a SinOkpy ROry 4. .35
ey Roses 1T.Pft (/Ay _ 4,L 2.3;
I 0'-"tre' par wPsf (/a _ 7-1 v.oq
cvej4 CIAy — /slOn6 (vrr FIr — y, j 3.69
r 2g a.rv'y F//'r+Pn/ai rPPK ;oIP M;d /P6.1 11146
-5 21 (arr,r'y F/v.ntrota�- rvi'�rSide Medd/ 6.9 '.,6
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. ✓3
Pursuant to the provisions and penalties of Chapter 155,Acts'1953,I hereby certify that the foregoing account is just and Correct, that the amount claimedis 1 lly due,after allowing all just redits
and that no part of the same has been paid.
DateLs
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.
369012 England, Anthony Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/27/15 Reimb Mileage 2/5- 5/29/15 $ 25.53
Total $ 25.53
1 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.
369012 England, Anthony Allowed 20
- In Sum of$
$ 25.53
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-11 Reimb 4343000 $ 25.53 1 hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
September 17, 2015
Signature
$ 25.53 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund