HomeMy WebLinkAbout321328 01/30/18 y AAM CITY OF CARMEL, INDIANA VENDOR: 36014.4;
CHECK AMOUNT: $********53.66
i. ONE CIVIC SQUARE CYNTHIA CANADA
CARMEL, INDIANA 46032 11508N6060
LUCKY D
CKYA E CHECK NUMBER: 321328
NOBLESVILLE CHECK DATE: 01/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 53.66 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 360144 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Canada, Cynthia Payee
11508 Lucky Dan Dr
Noblesville, IN 46060 In Sum of$ Purchase order#
360144 Canada,Cynthia Terms
$ 53.66 11508 Lucky Dan Dr Date Due
Noblesville, IN 46060
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or Invoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-5 Reimb 4343000 $ 53.66 Board Members 1/17/18 Reimb Mileage 11/15-12/27/17 $ 53.66
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
$ 53.66 Total $ 53.66
January 23,2018
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
Cost distribution ledger classification if 1pkmkll�—
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1800
MILEAGE CLAIM/7tinh� Cf-In�rl� 1�50Fs Lind
(GOVERNMENTAL UN1T3 y co f)iD o
ON ACCOUNT OF APPROPRIATION NO. FOR
COM,CE,BOARD,DEPARTMENT OR INSTITUTION)
FROM TO WO
SPEEDOMETER
MILES
Za POINT POINT START
+ AUTO
DATE FINISHNATURE OF BUSINESS TRAVELED @
PER MILE
LD
11 c 1 c
1 11
- 1
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ice. f a� c 1 1
11 c c m �►c J,t -kms S;
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AUTO LICENSE NO. TOTALS 65
+ 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 part of the same has been paid.
Date
JAN 2 2 Z
O18
BY: L..z