HomeMy WebLinkAbout321336 01/30/18 0.1"ll!"
CITY OF CARMEL, INDIANA VENDOR: 371639•ONE CIVIC SQUARE ALYSSA HOLSTEN CHECK AMOUNT: $**"****"60.67*
CARMEL, INDIANA 46032 209 VAILI COURT CHECK NUMBER: 321336
INDIANAPOLIS IN 46280 CHECK DATE: 01/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 60.67 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 371639 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Holsten,Alyssa Payee
209 Vali Court
Indianapolis, IN 46280 In Sum of$ Purchase Order#
371639 Holsten,Alyssa Terms
$ 60.67 209 Vali Court Date Due
Indianapolis,IN 46280
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
Po#ornvolce Description
Dept# INVOICE NO. ACCT#lfITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-1 Reimb 4343000 $ 60.67 Board Members 1/11/18 Reimb Mileage 12/5/17-1/10/18 $ 60.67
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
$ 60.67 Total $ 60.67
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
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
20 Vail Cmr+
( Vloliahapalis, )N qlq-zoo
PRESCRIBED BTSTATE HOARD OF ACCOD_NTs
GENERAL FOAM NO.101(1986)
USE
MILEAGE CLAI2v1
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(GOVFANMENTALDN1Ty
ON ACCOUNT OF APPROPRIATION'NO, FOR
(OFFICE,BOARD,DEPARTMENT OR INSTITUTION) -
DATE' FROM TO TER
READING + TO MILEAGE
za-L POINT .POINT START FINISH, NATURE OF BUSINESS MILES. p
TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns areto be used only when distance between points cannot be determined by;fixed'tnileage 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,aftez allowing all just credi
and thatlnq,l i lo,:the.same has been paid.
II SS
Date
1 /
( r
JAN 222018