HomeMy WebLinkAbout332958 12/06/18 CITY OF CARMEL, INDIANA VENDOR: 371639
CHECK AMOUNT: $********33.25*
., ONE CIVIC SQUARE ALYSSA HOLSTEN
CARMEL, INDIANA 46032 209 VAILI COURT CHECK NUMBER: 332958
INDIANAPOLIS IN 46280 CHECK DATE: 12/06/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 33.25 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 371639 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Holsten,Alyssa Payee
209 Vali Court
Indianapolis, IN 46280 In Sum of$ Purchase Order#
371639 Holsten,Alyssa Terms
$ 33.25 209 Vali Court Date Due
Indianapolis,IN 46280
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
Po#ornvoice Description
Dept# INVOICE ND. ACCT#ITITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-6 Reimb 4343000 $ 33.25 Board Members 11/28/18 Reimb Mileage 10/15-11/9/18 $ 33.25
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
$ 33.25 Total $ 33.25
November 29,2018
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 1PAH"VAVU
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Alaym " zol VOJI- Guv'ri
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1866)
MILEAGE CLAIM ` S S a
V ;/ TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR iNsn UnON)
D T FROM TO SPEEDOMETER AUTO ILE .G
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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,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allowing all just credits
end that`T;o�artjof the same has been paid.
Date ` (O•I� 110
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