HomeMy WebLinkAbout326228 06/12/18 J/ CITY OF CARMEL, INDIANA VENDOR: 358408
.I• ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $*******128.12*
�_�, CARMEL, INDIANA 46032 5057 E 71ST STREET CHECK NUMBER: 326228
"��liori�°' INDIANAPOLIS IN 46205 CHECK DATE: 06/12/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 128.12 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 358408 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Buckingham,Tiffany Payee
5057 E 71 st Street
Indianapolis, IN 46205 In Sum of$ Purchase Order#
358408 Buckingham,Tiffany Terms
$ 128.12 5057 E,71st Street Date Due
Indianapolis, IN 46205
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description
Deept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-2 Reimb 4343000 $ 128.12 Board Members 5/22/18 Reimb Mileage 12/6/17-5/10/18 $ 128.12
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
$ 128.12 Total $ 128.12
June 6,2018
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
all E C EX V 7-19 D
MAY 3 1 2018
Y: q -c-, } GENERAL FORM 110.101 11406)
PRESCRIBED BY STATE HOARD OF ACCOUNTS
/� MILEAGE CLAIM 1,6-onls
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(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
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PEEDOMETER AUTO iA1LEAGE
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AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or offidial highwaymap. , 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 allowing all just credits..
.Rd that_no_pR.t_of_1hesame_ s_been paid.
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