HomeMy WebLinkAbout331451 10/25/18 CITY OF CARMEL, INDIANA VENDOR: 364842
® ONE CIVIC SQUARE KATHLEEN VASIL CHECK AMOUNT: $*******171.60*
s. CARMEL, INDIANA 46032 3779 SIMMERMAN CT CHECK NUMBER: 331451
•M;`��r CARMEL IN 46033
„oN� CHECK DATE: 10/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 MILEAGE 171.60 TRAVEL PER DIEMS
1
Prescribed by Slate Board of Accounts I
0.��„l vc- A MILEAGE CLAIM C
TO Gold -GF5
(Governments nit
a.0`l On Account of Appropriation No. I
for
(Office, oar ,Department or Institution
1
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS )f AUTO MILES
20L8 Point Point Start Finish 1 TRAVELED
TX
�o tZt~ G sR GTU 2rf 1 845 5-1 R5'7
-1O( 5cls 12
a-aa I a`I� a qd16 I
3=t -t X7 a
3-I tIQ901< 5291-1
a sz J4) Z
= �t$
5364z- 5305 2_
533 z4O
-�s-I
533(-0 5 33-7a II
S353Z.
I'd12-
.3554
t-I-i a,Ig 53(pto
1 5396-55 a
S as-tg0517 1 12-
fo 5'q121 !
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3ILic
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1a
30
Auto License No. TOTALS
1 1
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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.
f I \I
Date
S General Form No.101 (1955)
MILEAGE CLAIM
TO I- e. Gy\G DR.
(Governments nit)
13 on On Account of Appropriation No. for
Office,Board,Department or Institution)
FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @ 1 S'5
Point Point Start Finish TRAVELED PER MILE
20 11 Q5-- GTO t2rl ) S8057 to 0
X01 ;5a Das I12
a�r1 Baa I �
( a 1
D.7 W ' a .
a 52,44qi
3042- 5 305 Z
1 533( 533 210
-.-.. -533(,0 7 I D-
Szb 3532
oto to',
5, 7`f1
3 R& 5 2
10 5 CL !
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5
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3 ti-r Y Al
, a
3o
I
Auto License No. TOTALS ! j_1 I (00
NG columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map,
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
J that no part of the same has been paid. \ I
V Q�