HomeMy WebLinkAbout301303 07/28/16 i
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'' CITY OF CARMEL, INDIANA VENDOR: 369557
® '�I ONE CIVIC SQUARE AIMEE RICH CHECK AMOUNT: $********74.63*
r° CARMEL, INDIANA 46032 4907 SUNVIEW CIRCLE#1222 CHECK NUMBER: 301303
�'fiue i� INDIANAPOLIS IN 46237 CHECK DATE: 07/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 070616 74.63 TRAVEL FEES & EXPENSE
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Voucher No. Warrant No.
Allowed 20
369557 Rich, Aimee
4907 Sunview Circle# 1222
Indianapolis, IN 46237 In Sum of$
$ 74.63
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#rrITLE AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 74.63 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
s-made-were-ordered-and- --- -
received except
July 20, 2016
'PAN"VK1A-)
Signature
$ 74.63 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
IRECEITED
I JUL 13 2016
PRESCRIBED BY STATE BOARD OF ACCOUNTS -
' GENBRAL FORM NO.101(1006)
MILEAGE CL TO
AM �' �93� �1
—�. �1
�Gy�p (Gov NMF]tIAL t
r 1 tk cta U �QY S n �Q,n f t�j•,a,�y� ON ACCOUNT OF APPROPRIATION NO.
�lJ` (DYFtcE,BOARD,DEPARTMENE OR IN3mUT1ON) •►C.` u_ �v�l
DATE
FROM TO SPEEDOMETER
READING +
AUTO MILEAGE
NATURE OF BUSINESS MILES @ .54 a
POIA'1 POINT START FINISH TRAVELED PER MILE
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6 5
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UP to CAV-PAIA lC "U— q
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AUTO LICENSE NO. TOTALS 1 .1 L� LQ 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 1953,I hereby certify that the foregoing account is just and correct,that the amount claimed is 1 By due,after allowing i credits.-
end that no part of the same has been paid.
Date
rte_.
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