HomeMy WebLinkAbout324908 05/09/18 � C4q
CITY OF CARMEL, INDIANA VENDOR: 371639
\ .® CHECK AMOUNT: $********55.04*
ONE CIVIC SQUARE ALYSSA HOLSTEN
CHECK NUMBER: 324908
a" CARMEL, INDIANA 46032 209 VAILI COURT
INDIANAPOLIS IN aszso CHECK DATE: 05/09/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 55.04 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 371639 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Holsten,Alyssa Payee
209 Vali Court
Indianapolis, IN 46280 In Sum of$ Purchase Order#
371639 Holsten,Alyssa Terms
$ 55.04 209 Vali Court Date Due
Indianapolis,IN 46280
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-1 Reimb 4343000 $ 55.04 Board Members 5/3/18 Reimb Mileage 3/22-4/26/18 $ 55.04
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
$ 55.04 Total $ 55.04
May 3,2018
I 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
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�Y:
PRESCRIBED BY'STATE.BOARD OF ACCOUNTS GENERU FORM'NO.101(1986)
MILEAGE CLAIM
ESE TO MILEAGE sa . . I eln
(GoyExtaeENrAt mail) ON ACCOUNT,OF APPROPRIATION'NO.. _ FOR - -
(OFFICE,HOARD.;DEPARTMENT OH TNSTITUTION)
DATE FROM _ TO SPEEDOMETER READING AUTO E
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CAUTO LICENSE NO. TOTALS 1 D
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage;or official.highway map.. 1 V
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 aliowing all just credits:
and that no,pant ofthe same has been paid.
Date
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