HomeMy WebLinkAbout258085 04/29/16 %'.4gq,,f. CITY OF CARMEL, INDIANA VENDOR: 370349
;: �. CHECK AMOUNT: $********79.92*
.;: �� ONE CIVIC SQUARE SHANE BURNHAM
s9� �a; CARMEL, INDIANA 46032 11874 SPRINGFIELD COURT CHECK NUMBER: 258085
,,,«oN� FISHERS IN 46038 CHECK DATE: 04/29/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 041116 79.92 EXTERNAL TRAINING TRA
VOUCHER NO. WARRANT NO.
ALLOWED 20
SHANE BURNHAM
11874 SPRINGFIELD COURT IN SUM OF$
FISHERS, IN 46038
$79.92
ON ACCOUNT OF APPROPRIATION FOR
Engineerinq
PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members
0 I 43-430.02 I $79.92 1 hereby certify that the attached invoice(s), or
2200 JC)L4 1k I `® 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,April 26, 2016
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Date Due
Invoice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
04/26/16 I 0 I Mileage to Bloomington for INAFSM Training I $79.92
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
GENERAL FORM NO.101(1955)
CLAIM
TO — � R(A Y1
ON ACCOUNT OF APPROPRIATED NO. FOR
MILEAGE
NATURE OF BUSINESS AUTO MILES @ 54.0 cents
TRAVELED PER MILE
TOTALS :2
,nileage or official highway map.
and correct;that the amount claimed is legally due,after allowing all
PRESCRIBED BY STATE BOARD OF ACCOUNTS
NHLEA(
�V 67-- CCA v-n-�
(GOVERNMENTAL UNIT)
rte.f i
(OFFIC ,BOARD,DEPART ENT OR INSTITUTION)
DATE FROM TO ODOMETER
READING+
2016 POINT POINT
START FINISH
1 CI Wq G]A r(i )-00 c 6I ct fJ
Cit 544q.-e..,m � o D
AUTO LICENSE NO.
+ODOMETER READING columns are to be used only when distance between points cannot be determined by fii
Pursuant to the provisions and penalties of Cha t155,Acts 1953;I hereby certify that the foregoing account is
Just redits,and that no part of the same has been paid.
Date Y I ,20 [