HomeMy WebLinkAbout254083 02/05/16 u'4`p'' CITY OF CARMEL, INDIANA VENDOR: 369107
j ® ONE CIVIC SQUARE MARK CONNORS CHECK AMOUNT: 5"""""11.67'
f9 ?� CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 254083
a„*oN.� CHECK DATE: 02/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 020116 11.67 TRAVEL FEES & EXPENSE
a r
JAN 2 7 2016
PRESCRIBED BY STATE BOARD OF ACCOUNTS WNERAL FORM NO.101 11986)
MILEAGE CLAIM ��1/
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f �vtei C.1�YKS ALDNIT)
ON ACCOUNT OF APPROPRIATION NO: FOR
(OIFICE,AOAAD,DEPAATM=OB INSTITUTION)
DAT FROM TO SPEEDOMETER
AUTO MILEAGE
POINT POINT START FINISH NATURE OF BUSINESS TRA E� ® ,SMS
PER MME
c7 t ntnl� escdow �-2 �.
OCrt- 21 `1 L% Y mw - exY� }u rY E e (o.
�v 11 otiu 1�N,e w _te S" e
AUTO LICENSE NO. TOTALS (C C I I 0 . l
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+ 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 1893,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all Just credits
end thal no part of the same has been paid.
Date
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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.
Connors, Mark Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)). PO# Amount
1/6/16 Reimb Mileage 10/12- 11/11/15 $ 11.67
Total $ 11.67
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.
Connors, Mark Allowed 20
i
In Sum of$
$ 11.67
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-11 Reimb 4343000 $ 11.67 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
January 27, 2016
Signature
$ 11.67 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund