HomeMy WebLinkAbout324413 04/25/18 iii%..fr9q�f
CITY OF CARMEL, INDIANA VENDOR: 359065
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ONE CIVIC SQUARE BOB HIGGINS
CHECK AMOUNT: $""""'34.65"
?4 CARMEL, INDIANA 46032 1895 WEST 211TH CHECK NUMBER: 324413
-9' irori"�°' SHERIDAN IN 46069 CHECK DATE: 04/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 34.65 TRAVEL PER DIEMS
Prescribed by Slate Board of Accounts
MILEAGE CLAIM
Ile S TO �'C�x�3 ���
Governmental nit)
)Qe 1-7'e'�7 On Account of Appropriation No. `T `dT for 41
Office,Board,Department or Institution
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DATE FROM TO ODOMETER READING NATURE OF BUSINESS
* AUTO MILE
20-LE9 Point Point Start Finish TRAVELED
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Auto License No. '
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* SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to.the,provisions and penalties of Chapter 155,Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just credits,and that no part of the same has been paid.
Date y_ /0 � /i�
I Claim No. Warrant No. I have examined the within claim and
I hereby certify as follows;
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as requi
by law;
. That it is based upon statutory author
l S41�OS� That it is apparently correct
incorrect
On Account of Appropriation No. �a�d for
j Disbursing Officer
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Allowed -20 10-
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in the sum of$ o .
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(Board or Commission) iol- ID
FILED CD
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(Official Title)
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