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HomeMy WebLinkAbout319761 12/15/17 CITY OF CARMEL, INDIANA VENDOR: 369557 ONE CIVIC SQUARE AIMEE RICH CHECK AMOUNT: $**.....139.74* CARMEL, INDIANA 46032 4907 SUNVIEW CIRCLE#1222 CHECK NUMBER: 319761 INDIANAPOLIS IN 46237 CHECK DATE: 12/15/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 139.74 TRAVEL FEES & EXPENSE Voucher No. Warrant No. Allowed 20 369557 Rich, Aimee 211 Junction Pass#2G Westfield, IN 46074 In Sum of$ $ 139.74 ON ACCOUNT OF APPROPRIATION FOR 108 -ESE Board Members PO#or INVOICE NO. fkCCT#/TITLE AMOUNT Dept# 1081-99 Reimb 4343000 $ 139.74 I 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 December 8, 2017 P* Signature $ 139.74 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund d FDEC 0 5 2017 BY:.............................. PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1905) MILEAGE CLAQIMI-rrav�� 2�r •D IM JCb(-0Jq y 2j��j QQ l.4 �C k xideel Ctc-A �n110n m n f- tQ C` urQ AL Wan ON ACCOUNT OF APPROPRIATION NO: For— (OFFICE, O r(OFFICE,BOARD,DEPAATMFN7 OA 1NSnTUTION( DATE FROM TO SPEEDOMETER READING i_ AUTO MILEAGE 20 POINT POINT START NATUISHRE OF BUSINESS MIL L � SYgm PER MILE vs 1 3 01 S ' "7 L& ID I w Vi k $ l L 5� 2 6*3 to• Co p : r $jis.A' i S " O 160t(5 P 1 1. a 41 Co t T i 1 (o•1 RU- :UAd^si to.I to 11 "ft- 'fM - ; 4. l '1fo � R U. W,1b G- 'Si i t0. ` �*- q, 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 1853,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing alljust or and a} part of'tlie=sarae'lias been paid. Dat 2,- 11:11111 !� Willrit.t"`iUUIa1i�dfi',iSS DEC 0 5 2017 BY:.............................. PRESCRIBED By SLATE BOARD OF ACCOUNTS GENERAL FOAM NO.101(1986) MILEAGE CLAIM! hided Sc hc�l �nrtUn rn +- TO_ TrOly e,� 1�2r i e.m tc ,t-0l�-y 3N3 0014 (GOVEAMLKIAL UNIT) 1 'r C.Lp ON ACCOUNT OF APPROPRIATION NO. (OHICE,BOARD,DEPARTMENT OR 1NSnrinlON) V ..;'r/1 I)"s!9 a, ,.✓w ', L DATE FROM TO SPEEDOMET,'ER t�---�--=-�-� READING AUTO MILEAGE POINT POINTSTART FINISH NATURE OF BUSINESS MILES CW .g35 a TRAVELED PER MILE 1 -6Nli ,s . 1.7-.,%3 . 2 lt� i nc to a L. l� kic to 1 b Z ito 10 ityr k - io 1Z Ulf T _ t t l O tl r 1C a �I tr .6 Lt 0 1 a r r"I2 D3 — c .3 b iL -N 2 yr 2Ca AUTO LICENSE NO, TOTALS 1 + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined bir fixed mileage or official highway.map. Pursuant to the proyisio v i, d 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 11"m a�r^`r :and that no gait of the same Jrhas been paid. Date � Z I