HomeMy WebLinkAbout253062 01/11/16 +yr,Cqq�
CITY OF CARMEL, INDIANA VENDOR: 370171
"® �', ONE CIVIC SQUARE INDU GARG CHECK AMOUNT: $********34.96*
=Q; CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 253062
'''„TON�° CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 34.96 TRAVEL FEES & EXPENSE
DECCEP� 7716E
2 1 2015
PRESCRIBED BY STATE BOARD OF ACCOUNTS Yr. GENERAL FORM 110.101(1995)
3
MILEAGE CLAIM oCnk Ga��
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
SSC '
(OFFICE,BOARD,DEPARTMENT OR INS MYTION)
SPEEDOMETER AUTO )BLEAGE
1 FROM TO READING +
NATURE OF BUSINESS MILES 7 G)
POINT POINT START FINISH TRAVELED PER MILE J
i KI& CO 6 Y `JU. nc . U 2
1 tno� re R he i°r r daWt o 75
e rr` o o r �t 1
teT C v Av ,Vic,e 0f ci f F 2
IAC 61v( e-ve- _�T%r 0.e oo I D
i
t y V "O>n M-eaozo \ 10 ° 2
OC L3iA \A�0, , o e- v -e-e-
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AUTO LICENSE NO. TOTALS CSO r I/ 3
+ 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 1953i I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits.-
and
redits:and that no part of he same has been paid.
Date 12''
r
����ris
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.
Terms
Garg, Indu
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/17/15 Reimb Mileage 2/2- 10/13/15 $ 34.96
------------
Total Is 34.96
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
i
Voucher No. Warrant No.
Allowed 20
Garg, Indu
In Sum of$
$ 34.96
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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PO#or INVOICE NO. ACCT#/TITLE AMOUNT i Board Members
Dept#
1081-2 Reimb 4343000 $ 34.96 l 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
i
{ received except
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l
December 22, 2015
Signature
$ 34.96 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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