HomeMy WebLinkAbout322053 02/19/18 (9, -
CITY OF CARMEL, INDIANA VENDOR: 359065
ONE CIVIC SQUARE BOB HIGGINS CHECK AMOUNT: $*}* 4•■k 2289*
CARMEL, INDIANA 46032 1895 WEST 211TH CHECK NUMBER: 322053GL O SHERIDAN IN 46069 CHECK DATE: 02/19/18
DEPARTMENT i ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 MILEAGE 22.89 TRAVEL PER DIEMS
Prescribed by Slate Board of Accounts
MILEAGE CLAIM
`�2r TO
(Governments nit) r
1,2 a On Account of Appropriation No. for�j�
(Otfice,13oard,Department or Institution
I
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES
20-LE Point Point Start Finish TRAVELED
t i r c, 1
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II
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, fter
allowing all just credits, and that no part of the same;has been paid.
Date
�- la- /op
I
t Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as requi:
by law;
li
That it is based upon statutory author
correct
$ aoZ �jQ That it is apparently I incorrect
On Account of Appropriation No. for I'
Disbursing Officer
O
Allowed 20
�g �
in the sum of$
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4d NDP
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OCD
(Board or Commission)
1 FILED �.
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