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HomeMy WebLinkAbout324317 04/25/18 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 $ 118.26 11508 Lucky Dan Dr Date Due Noblesville, IN 46060 ON ACCOUNT OF APPROPRIATION FOR 108-ESE PO#or INVOICE N0. ACCT#frITLE AMOUNT Invoice Description Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-5 Reimb 4343000 $ 118.26 Board Members 4/2/18 Reimb Mileage 1/9-3/28/18 $ 118.26 I 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 $ 118.26 Total $ 118.26 April 17,2018 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance l� 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 I as ' aF.MAL FORM RO 101 119M MSCMIED BY STATE BOAND OF ACCOUNTS _ MILEAGE CLAI 4 'a K' TOS' A� 1GOVEOMENTALUNM ON ACCOUNT OF APPROPRIATION NO. FOR — i LOM,CE.BOARD.DUARTMM OR HISTTTUTION) SPEEDOMETER AUTO C nn FROM TO I^ READING �- NATURE OF BUSINESS7RA EV Lfib POINT POINT START FINISH PER M0 L'�b --— 1 – w4rrrr n C-C- � n EIS . C C- c �� a2 t✓ 2 C- r n 46 W-t ' irT ° �t1 Ae— VY\T ^ - in 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 11153,l hereby certify thal the foregoing account is)ust aad correct,that the amount claimed is legally due,after a q ust credits.- end Ihat n Dateo pa of the_same has been paid, t --,im i Rr 6 1018 rAPR : NoUe�v kl 2 f ZVlS cj(Q c�(Q Com. PRESCRIBED BY STATE BOARD OF ACCOUNTB GENERAL FORM NO.101(1US) MILEAGE CLAIM TO (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTMENT OR INSTITUTION) Z DAA TE FROM TO SPEEDOMETER AUTO EAG 01 READING { NATURE OF BUSINESS MILES p 4 POINT POINT START FINISH TRAVELED PER MILE YM Y- m rn c_L rn ON cc VY1 r r tin o i m-r L c— 3. 1 � " - ILl Yh ' c rec VA fhi' th G fhQrt_ n AUTO LICENSE NO. TOTALS tcreI + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. , - —u*—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 a )u and thatno part off the same has been paid. H 1 Date 1 QLI l 6 . 1 V. OY( APR 16 2010 BY: