HomeMy WebLinkAbout305751 12/07/16 CITY OF CARMEL, INDIANA VENDOR: 371363
CHECKAMOUNT: $********49.14*
(9' .
ONE CIVIC SQUARE DONNA AIKENCARMEL, INDIANA 46032 ESE EMPLOYEE CHECK NUMBER: 305751
CHECK DATE: 12/07/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 49.14 TRAVEL FEES & EXPENSE
i
Voucher No. Warrant No.
Aiken, Donna Allowed 20
ESE Employee
In Sum of$
$ 49.14
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#!TITLE AMOUNT Board Members
Dept#
1081-4 Reimb 4343000 $ 49.14 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 except
November 23, 2016
L�.
Signature
$ 49.14 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
-- ,*
GENERAL FORM 110.IBI(1986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS MILEAGE CLAIM
- TO
�'
(GOVERNMENTAL UNrt1 ON ACCOUNT OF APPROPRIATION NO. FOR
(OpicP,BOARD,DEP"TRINr ON 1Nstmul0N)
- -- SPEEDOMETER AUTO I11I.E E `'
FROM TO READING + MILES @ 5
DATE '� NATURE OF BUSINESS TRAVELED `
POINT POINT START FINISH PER MI(�
- " I
IT Mn n
157
W cr d Ian
CDC-
k.2 aid-c
_ 9
In
TOTALS
AUTO LICENSE NO- /
+ 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 le ly due,alter Ing all •usl credits.-
Pursuant
and that no IT t of t to same has been paid.
Date
NOV 2 3 2016
BY: