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HomeMy WebLinkAbout303890 10/10/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 360144
ONE CIVIC SQUARE CYNTHIA CANADA CHECKAMOUNT: $*******389.03*
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK NUMBER: 303890
NOBLESVILLE IN 46060 CHECK DATE: 10/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 091916 322.02 TRAVEL FEES & EXPENSE
1082 4343000 091916 67.01 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of$
$ 389.03
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-5 Reimb 4343000 $ 322.02 1 hereby certify that the attached invoice(s), or
1082-14 Reimb 4343000 $ 67.01 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
October 4, 2016
signature
$ 389.03 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ACCOUNTS PAYABLE VOUCHER
CITY OFCARMEL
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.
360144 Canada. CyDdi Terms
115D8Lucky Dan Or
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
Mileage 8/4-12/22115
Total $ 389.03
|hereby maffify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with|C541'1O4.o
. 2D___
Clerk-Treasurer
_ _ _
ISO ���1�� ���. 'AY-
i
SEP 2 9 2016 '
PRGSCRIEED B7 STATE HOARD OF ACCOUNTS GENERAL FORM NO.101(1980
SY: ILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO- FOR
1OF:1cr,BOARD.DFiARTMrxr oa INSTITUTION) '
SPEEDOMETER AUTO 21ILE E
DATE FROM To READING +
MILES ® G4 G f
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
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AUTO LICENSE NO- TOTALS 9 y`91
+ SPEEDOMETER.READING columns ere to be used only when distance between points cannot be determined by fixed mileage or official highway map. swc
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 credits
end t(haIt part f the same has been paid.
Date
q
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RECEIZTED Vvc�\��u'� ll�, �iN q 000Lz'(D
SEP 2 9 2016
PAMCRIBED BY STATE BOARD OF ACCOUNTS GEIIERAL FOAL!NO.lei Cann
BY: MIL AGE CLAIM
rorC lC� CCJ'Z
1GOVERNNENrAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DE}ARnCE TT OA INSrMMON)
All!J FROM TO SPEEDOMETER AUTO �ftii EIDE
READING i- NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVEL= PER MILE
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AUTO LICENSE NO. TO S 1 Qo 1 �ot
+ 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 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits.
end that nq part pf the same has been paid.
Date 1 1 Le
O
CE�VE� '13 DU
SEP 2 9 2016
PAlSCN1ECD H7 STATE HOARD OF ACCOUNTS BY•r--`--_ '
GENIMAL FOAM 110.101(INS)
GE CLAIM .�r 9 , n �� _—
(GOVMAENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. �FOR
tOMCF,BOARD.DElAAThUXT OA INSTITITNON)
SPEEDOMETER
D�y`TlE� FROM TO READING + NATURE OF BUSINESS AMILES ® out E e
–{Yt POINT POINT START FINISH TRAVELED PER max
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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 credits.
end that o part 1 the same has been paid.
Date
RECEIVED t36Uesv
SEP 2.9 2016
F A
PMCRIBED BY STATE BOARD OF' Br_• GENFAAL FOplid.G.IQl t1785)yl - AGE CLAIM
� ro
(GOVON(ENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE,BOARD,DEPARTICWT OR INS ITVnON)
FROM TO SPEEDOMETER AUTO MILE4GE
DpTg READING + NATURE OF BUSINESS MILES ® o c�� t
t•-,-` v� POINT POINT START FINISH TRAVELED PER max
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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 credits
end that no part ofj the same has been paid.
Date
log
pf
DECEInbl e Sv t I l JCS LjLOpUD
SEP 2 9 2016
PRESCRISED B7 STATE BOARD OF ACCOUNTS Gn1FAAL FOAL 110.101 tmn
BY: MIL GE CLAIM C- l -c
—" To Y
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFICF,BOARD,DEPARTMFM OB INSTQUIION) -
i SPEEDOMETER AUTO E
D TE FROM To READING +
NATURE OF BUSINESS MILES ® g �
_ POINT POINT START. FJNISH TRAVELED PER max
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TOTALS &I
AUTO LICENSE NO. T 1
+ 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 credits.
and that no partpf the same has been paid..
Date �
v��
15u Lc�Glc��
j SEP 2 9 2016
PRESCRIBED BY STATr BOARD OF AOCOLMS ,n GOIF.RAL FORM 110.IBI(1486)
Y' E CLAIM
ro
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFE)CF,BOARD,Dr1ARTl@FE OR 1N MMON)
FROM TO SPEEDOMETER AUTO JdR„E?10E
g9�w a c READING + NATURE OF BUSINESS MILES (¢� `� t
L POINT POINT START F)NiSH TRA—K. PER MHz
n '4-Ln' C---M[2
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AUTO LICENSE NO. TOTALS 1 0
+ 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 duo,after allowing all just credits:
end that nop1art.of the same has been paid.
Date h L � '
RECEIVE� � �eS v► ll� , .� �I(�c�(�C`
SEP 2 9 2016
PRESCRIBED BY STATE BOARD OF ACCOUNTS
i GF AJLL FORE!NO.101(1900
MILEAG CLAIM 11
(GOVMMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OF7cE,BOARD,DEPKRTW3D(T OR INSrnUIION)
DATE
FROM TO SPEEDOMETER AUTO tiII4
READING
NATURE OF HUSINESH MILES
Ra POINT POINT START FINISH TRAVELED PER MILE
0. f 1614-4 1t
Y
Cleo ip'I e-
R 11-4
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9 c--
9
ter- n
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E13--A fn
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 2953,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits.
end that no
part.of the same has been paid.
Date
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