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HomeMy WebLinkAbout329608 09/05/18 a`! CITY OF CARMEL, INDIANA VENDOR: 360144 ® ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: $*******160.55* CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK NUMBER: 329608 NOBLESVILLE IN 46060 CHECK DATE: 09/05/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 160.55 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 360144 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Canada, Cynthia Payee 11508 Lucky Dan Dr Noblesville, IN 46060 In Sum of$ Purchase Order# 360144 Canada,Cynthia Terms $ 160.55 11508 Lucky Dan Dr Date Due Noblesville, IN 46060 ON ACCOUNT OF APPROPRIATION FOR 108-ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-5 Reimb 4343000 $ 160.55 Board Members 8/20/18 Reimb Mileage 4/4-8/3/18 $ 160.55 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 $ 160.55 Total $ 160.55 August 24,2018 1 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 CFWMAL FOAM RO J0111990 eACSCmeeD BY STATt BOARD OF A[SOUNTS MILEAGE CLI j.11 A� '—` . TO fI G�� � �G jGOVnDn1ENrAL um ON ACCOUNT OF APPROPRIATION NO. FOR — iOF?JCE,BOARD,DErAR'DQTR OB n;smmloN) -- �„ qpEEDOMET FROM TO I—` READING +� NATURE OF BUSINESS MILES o-5 ZAGE DA�TE � � POINT POINT START FINISH �VELM PER MILE e A— 2 t T— s Yv�c _ I A a Sl1 C_ ' re lk—re <_ fy\ —-- m! !_ - s AUTO LICENSE NO. TOTALS + SPEEDOMETER READING columns are to be used only when dislance between points cannot be determined by fixed mileage or official highway map. L p Pursuant to lite provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is lusl and correct,that the amount claimed Is legally due,afterali6wini all}uel'c>edits 'SJ and thai?p -part of the same has --been paid. � Date ` AUG 232018 l 1 I1 509 L..u..c—t�k-s i�sc--r\ fir GFlD'AALfOAM NG 1P1{]9861 PMCM!£D BY STAT£BOARD OF ACCOUNTS MILEAGE CLAIM TO_ a—, IGOVEIWMENIAL 110M ON ACCOUNT OF APPROPRIATION NO. FOR — -' tofPICE.BOARD.DEPARTMW OA 19Snfm'ION) FROM TO — — �'— BEADING TI]t AM= @ DATE NATURE OF BUSINESS X17-..j- � POINT POINT START FINISH TRAVELED PER MILE -- — 1MT i SI`n�rZ�r. M L C- _ 4-. gag -__- � IL AUTO LICENSE NO. TOTALS m + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map, going account is just and cozrecl,that the amount claimed is legally due,after allowing all Lust credits Pursuant to the provisions and penalties of Chapter 185,Acts 1953,I hereby cattily that the fore . and that no pari of t Te same has been paid. Date CLIVEID AUG 2 3 2010 RY: PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM NO.101(19116) MILEAGE CLAIM C - �C TO_ -—_—�A t'-1 {GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPARTMENT OR INSTITUTION) FROM TO SPEEDOMETER DAT READING -{ AUTO Za POINT POINT START FINISH TRAVELED OF BUSINESS TAMILES A FLED a C MILEAGEC PER MILE cq Me- l- IM "r S' �� c 2 C.L i hT SC �e-. 'c rrr Ne V7 A-6 t , i 1 v ca 3n LNr.�Ca c rrn T 31 r irk I �- C_ ve (^ c_c_ / AUTO LICENSE NO. TOTALS j r W + 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,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits and that nq part of 1he same has been paid. Date ifAUG 2 32018 :...._.._ ::.