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HomeMy WebLinkAbout320217 01/04/2018 u" CITY OF CARMEL, INDIANA VENDOR: 368929 : CHECK AMOUNT: S********53.79* b =` ONE CIVIC SQUARE LESLIE WIMBERLY CARMEL, INDIANA 46032 C/O PARKS DEPT CHECK NUMBER: 320217 �7/ CHECK DATE: 01/04/18 �3iTUM�O DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION__ 1081 4343000 REIMB 53.79 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER. CITY OF CARMEL VOUCHER NO: WARRANT NO.' ; Ap invoice of bill to be.properly itemized must show;kind,of service,where performed;dates service rendered,by Vendor# 368929 Allowed ` 20 whom rates per day,number of hours,rate per'hour,number of units,price per unit;etc: Wimberly, Leslie Payee . . . . . . . . . . . . . .. . . . 10832 Club,Circle Indianapolis; IN 46229: In Sum of 368929. Purchase Order.# . . . Wimberly,Leslie Terns 10832 Club Circle: Pate Due $: 5319 . . Indianapolis,.IN 46229 ON ACCOUNT OF'APPROPRIATION FOR 708.ESE, Po#or Invoice Invoice Description INVOICE NO. ACCT.#rrITLE 'AMOUNT Dept# Date Number (or note attached irivoice(s)or bill(s)) PO:# Amount ' 1081-8: Reinlb 4343000: $ 53.79 Board Members 12/5/17. : Reimb Mileage 9/25-72[5/17 $_ 53.79. 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 madewere ordered and received except $ : : :53.79 : Total', $ : 53.79 'December 27,2017 hereby .certify,that the attached invoice(s),or bill(s)is(are)true.and correct and:l have'sudited same in accordance with.IC 5,1.1=10-1.6 Post distribution ledger classiflcation.if; . claim paid motor vehicle highway fund Signature 20_ Accounts Payable Coordinator Clerk-Treasurer. Title . PRESCRIBED BY STATE BOARD OF ACCOUNTS J / , GENERAL FORM NO.101(19867 MILEAGE CLAIM TO �OVERdNICENSAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FO (OFFICE,BOARD,DEPARTMENT OR INSTnUTION) 'SPEEDOMETER DATE FROM TO I READING .1- AUTO MILEAGE 1-7POIATT POINT START FINISH NATURE OF BUSINESS MILES TRAVELED ED ®� G PER MILE _ 'LZ5 LLQ ,- R G& VE, L4 11 7- PV PV n 2 0 Cl - e lv>' G '+ 2 -1 o .O to c4sn us'nA- 9 M cy 2t tw/� S° 31 1 Islez, *A&W?A4ftMA9!ET g 9 1C) 30 15(Zl�iG -L y -7 ),neo 9 M v 2 185 it 1-7 1 'Siz 3118 i -9a nc c r✓ rI'n z 0`5 To--a6j,2+m a ✓ joblaid rb 2Cl ncc� ILL 2 S' M CG '. _ I 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 yihatthe_foregoing account is just and correct,that the amount claimed is legally due,after Oloying all ' st Credits.* and that part of the ame has been paid. Date DEC 12011 Club 6rd-c- ' A&22�