HomeMy WebLinkAbout250544 10/20/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 065950
ONE CIVIC SQUARE DIANA CORDRAY CHECK AMOUNT: S"'****'40.97'
CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK NUMBER: 250544
CARMEL IN 46033-9501 CHECK DATE: 10/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 40.97 TRAVEL PER DIEMS
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
( ^�
Va
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
(� ALLOWED 20
IQIA IN SUM OF
i
$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
I
i
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I
Prescribed by State Board of Accounts MILEAGE CLAIM General Form No.101 (1955)
_
�. C. B C" /*C/ TO akJN DR.
(Governmental Unit) �
l� t 7r On Account of Appropriation No. 4 U for
(Office,Board,Department or Institution)
DAJ� FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE C
20 Point Point Start Finish TRAVELED PER MILE
�f A OS f. Ql' 114 O
I
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 claimed is le Ily due, after
allowing all just credits, and th t/noo part of the same has been paid.
Date
ti
Claire No. Warrant No. I I have examined the within claim and
hereby certify as follows:
IN FA OR OF
)� That it is in proper form;
i That it is duly authenticated as required
j I by law;
That it is based upon statutory authority;
-�
4 That it is apparently orrect
L in—c-3ffect
On Account of Appropriation No. I for
Disbursing Officer
Y m
Allowed 20 ¢
I e o
Cr
in the sum of$
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(Board or Commission) �t O
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