HomeMy WebLinkAbout256525 03/15/16 �� 4�q\f!
CITY OF CARMEL, INDIANA VENDOR: 359285
® �I ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $*******156.56*
d.. �� CARMEL, INDIANA 46032 2703 E LYNN ST CHECK NUMBER: 256525
+.y��TON�° ANDERSON IN 46016 CHECK DATE: 03/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 031416 156.56 TRAVEL FEES & EXPENSE
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.
359285 Simmonds, Valeska Terms
2703 E Lynn St Date Due
Anderson, IN 46016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/12/16 Reimb Mileage 11/30/15-2/12/16 $ 156.56
Total $ 156.56
I 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
r
MAR 0 3 ?016
MSCRILCD BY STATE BOARD O1-ACCOUNTS _Yj r h .ry _ , GEN}F.PAL FORD 110.101(w0�
MILEAGE CLAIM � � v .. � r - '1 t�Y
TO )
tanvERN mENrAL IRIITI ON ACCOUNT OF APPROPRIATION NO, FOR
(OFFICE,BOARD,DEPARTI ENr OR INSTITUTION)
FROM TO - SPEEDOMETER AUTO MILEAGE
,r..wD g POINT PONT START FINISH
F NISH NATURE OF HVSTHESH 1RAEL n td PER MI-LE t
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AUTO LICENSE NO. TOTM
+ SPEEDOMETER READING Columns are to be used only when distance between points cannot be determined by fixed mileage or official highway.map. V►Z& r
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 legall due,after allowing all just Cre its r
and that no part of the same has heen.ga)d,,r
Date
4304
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MAR 0 3 2010
BY
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENF.HAL FORM NO.IOl(1086)
MILEAGE CLAIM
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O ON ACCOUNT OF APPROPRIATION NOr FOR
(OFFICE,BOARD,DEPARnlEIFT OA 1NST1Tmiou)
DATE FROM TO SPEEDOMETER
READING + AUTOMILEAGE
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POINT POINT START FD41SH NATURE OF BUSINESS TRAVELED PER MILE
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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,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just ared•s,
end that no part of the game has been paid. ,{ t
Date
I
. . MA S V16
PRESCRIBED BY STATE BOARD OF ACCOUNIs+
GEN ALFORM NO.IB)(1986)
MILEAGE CLT
(GOVYANMENTAL
ACCOU T F APPROPRIATION NO, FOR
(OFi7eE,BOARD,OETARTMEt{I OA 1NSI(TUr10NJ
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POINT POINT START FINISH NATURE OF BUSINESS 1'AA�ELEO9
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_ AUTO LICENSE NO. TOTALS E[y
SPEEDOMETER READING columns are to be used only when distance between points cannot be determin d by fix d Ue4ge or alfteial,highway.map. D'• t 7 1
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing acc unt is ju a d correct,that the amount claimed is-lega�] due,alter owing all just cred'
and thatllla,pal�t of}1JW a aha been paid. jj t
Data
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