HomeMy WebLinkAbout256639 03/18/16 CITY OF CARMEL, INDIANA VENDOR: 370349
ONE CIVIC SQUARE SHANE BURNHAM
CHECK AMOUNT: $********67.06*
CARMEL, INDIANA 46032 11874 SPRINGFIELD COURT CHECK NUMBER: 256639
(9,
FISHERS IN 46038 CHECK DATE: 03/18/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 031716 67.06 EXTERNAL TRAINING TRA
VOUCHER NO. WARRANT NO.
SHANE BURNHAM ALLOWED 20
11874 SPRINGFIELD COURT IN SUM OF$
FISHERS, IN 46038
$67.06
ON ACCOUNT OF APPROPRIATION FOR
Engineerinq
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members
0 I 43-430.02 I $67.061 1 hereby certify that the attached invoice(s), or
2200 201
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
Tuesday, March 15, 2016
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Irescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by
Nhom, rates per day, number of hours, rate per hour, number of units, price per unit,etc.
Payee
Purchase Order No.
Terms
Date Due
nvoice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
03/10/16 I 0 I Mileage-Purdue Road School I $67.06
2200 201
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
20Clerk-Treasurer
GENERAL FORM NO.101(1955)
CLAIM
TO S�ar,e B u�n►-,am
ON ACCOUNT OF APPROPRIATED NO. FOR
MILEAGE
NATURE OF BUSINESS AUTO MILES @ 54.0 cents
TRAVELED PER MILE
R-0" -5'C-i--%0C) 1
z3.3
TOTALS t 2 N. 2
iileage or official highway map.
ind correct;that the amount claimed is legally due,after allowing all
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAG
ccu-y�-el
(GOVERNMENTAL UNIT)
(OFFICE,BOARD,DEPARTMENT OR INSTITUTION)
DATE FROM TO ODOMETER
• READING+
2016 POINT POINT
START FINISH
O!; OCI Corry e1 -Cj'.i, c Seize. Purdue u�-,'�v. 8125 I 1 .i Perdu
cif C Sq. 818 .i 82y 9.2
AUTO LICENSE NO.
+'ODOMETER READING columns are to be used only when distance between points cannot be determined by fixe
Pursuant to the provisions and penalties of Chapter 155,Acts 1953;I hereby certify that the foregoing account is ji
Just credits,and that no part of the same has been paid.
Date " 1%4 1 I b ')0
L•
Shane
Burnham
City of Carmel
I, ,ISI
ti' ; s "jla
CONFERENCE
& EXP
2016
OR TION
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