HomeMy WebLinkAbout320055 12/21/17 4%" ''f•- CITY OF CARMEL, INDIANA VENDOR: 371247
d 3j ONE CIVIC SQUARE DIANNE WALTHALL CHECK AMOUNT: $*'*`****21.40*
Jaa. CARMEL, INDIANA 46032 1818 ARROWWOOD DR CHECK NUMBER: 320055
CARMEL IN 46033 CHECK DATE: 12/21/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 MILEAGE 21.40 TRAVEL PER DIEMS
Preseri6ed by State Bowd of Accounts General Form No.;to1(1955)
MILEAGE-CLAIM. }
TO Di anti ,
(Govemmenta Unit)
(�{Q r�{' / pull 1'P 1' On F1cc`ourttofAPP?oPriafiocllo. for {
tflce,Boa epartment or ns t on)'
DATE FROM. TO
ODOMETER READING NATURE OF BUSINESS AUTO MILES MILEAGE @.536
�. 20 1 1.' Point Point. Start Finish TRAVELED PER MILE;
1 C, 14 Dv t.l_ E 1 C
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'SPEEDOMETER READING columns are to be used only when,distance between points cannot be deterrnined.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 s justand correct,that the amount claimed is legally due,aft
t allowing all Just credits,and ttia no:part of the same.has been paid..
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