HomeMy WebLinkAbout252268 12/08/15 Cly .
CITY OF CARMEL, INDIANA VENDOR: 363065
® 3r ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $*******151.20*
,. ?4 CARMEL, INDIANA 46032 C/O PARKS-ESE CHECK NUMBER: 252268
CHECK DATE: 12/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 151.20 TRAVEL FEES & EXPENSE
DEC - 2 2015
ENERAL FORM 110.101(1906)
PRESCRIBED BY STATE BOARD OF ACCOUNTS 7-qj,
MILEAGE CLAIM �-
TO
_IOOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTWM(T OR INSTRUTION)
AUTO
FROM TO SPEEDOMETER NSLEAG�F
READING + d S
�DA NATURE OF BUSINESS MILESTRAVELED
POINT POINT START FINISH PERER
MILE
- O. ----- -
10.
10.
. Z ---
M
+o
Cw _
me_
G 10 CL 1
10 --
t0 .
— ID.
Cc -- 22. t
I °� Zs. t
--
1C• t ,�
1 m
AUTO LICENSE NO. TOTALS I l�a,9 S I 0a
+ 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' lega due,a ter aliowin all just credits
end that no pa� of the same has been paid.
Date 1- --- ��
v
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.
363065 Dowell, James Terms
9353 Barcroft Dr, Apt A
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/2/15 Reimb. Mileage 10/19- 12/2/15 $ 151.20
Total $ 151.20
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
120
Clerk-Treasurer
Voucher No. Warrant No.
363065 Dowell, James Allowed 20
9353 Barcroft Dr, Apt A
Indianapolis, IN 46240
In Sum of$
$ 151.20
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept# INVOICE NO. CCT#/TITL AMOUNT
1081-3 Reimb. 4343000 $ 151.20 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
December 3, 2015
Signature
$ 151.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund