HomeMy WebLinkAbout303816 10/06/16 Q
CITY OF CARMEL, INDIANA VENDOR: 370120
CHECKAMOUNT: $*******"84.67'
ONE CIVIC SQUARE AUDREY COOPERCARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 303816
CHECK DATE: 10/06/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 091916 84.67 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
_________
Allowed 20__
370120 Cooper, Audrey '
54OZephyr Way
Westfield, IN 46074 In Sum of
ONACCOUNT OFAPPROPRIATION FOR
1Q8 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-3 Reimb 4343000 $ 84.67 \ hereby certify that the attached invoice(a). or
bi||(s) is (om)true and correct and that the
materials orservices itemized thereon for
which charge iamade were ordered and
received except
September 26 2016
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Signature
Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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
370120 Cooper, Audrey
540 Zephyr Way
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/19/16 Reimb Mileage 6/28-9/19/16 $ 84.67
Total $ 84.67
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
5 = ... REEIVED
r r•
SEP 2 2 2016
BY:
GENERAL FORM SSC.SOI(1996)
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE,CLAIM ,}
LC�t— TO
vFRNMENTAL UNIII ON ACCOUNT OF APPROPRIATION NO. FOR
S
{OFFICE,BOARD,DEPARTMENT OR INSTITUTION)
FROM TO _ Sf'EEDQMETim AUTO M
Fi'eADING {- NATURE OF BUSINESS MILES r
POINT POINT START FfNISfI TRAVELEDI RA
PER MI E
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AUTO LICENSE NO. �! TOTALS t
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be deterT�iined 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 le q ane, fter allowing a just credits
and that no'p art of,th same has-been paid.
Date
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