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HomeMy WebLinkAbout332989 12/06/18 CITY OF CARMEL, INDIANA VENDOR: 366267 w, ONE CIVIC SQUARE ASHLEY ULBRICHT CHECK AMOUNT: $*******680.38* CARMEL, INDIANA 46032 CARMEL CITY_HALL CHECK NUMBER: 332989 M,iTON�p 1 CIVIC SQUARE CHECK DATE: 12/06/18 CARMEL IN 46032 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343004 MILEAGE 680.38 TRAVEL PER DIEMS VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) Vendor# 366267 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ASHLEY ULBRICHT IN SUM OF$ CITY OF CARMEL CARMEL CITY HALL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service 1 CIVIC SQUARE rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CARMEL, IN 4.6032 Payee $680.38 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Department of Law Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT Mileage 43-430.04 $680.38 I hereby certify that the attached invoice(s),or 11/29/18 Mileage $680.38 1180 101 1180 101 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 Thursday, November 29,2018 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 .120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer I PRESCRIBED BY STATE BOARD OF ACCOUNTS MILEAGE CLAIM TO City of Carmel Indiana (GOVERNMENTAL UNIT) Department of Law - 1180 ON ACCOUNT OF APPROPRIATION NO. 434-3004 FOR Mileage (OFFICE,BOARD,DEPARTMENT OR INSTITUTION) DATE FROM TO SPEEDOMETER AL READING + F NATURE OF BUSINESS MI POINT POINT START FINISH TRA1 Atn� Q411 , eK ;n c� w. 1 „ 'e- '1411 e- �,+2 cam,-• „ ., 17 il. �rcc.iwls a-7 11 csiU e i" S II 5 W10.1 l a�i YV1 � •� � C a\\ r1S Y1 �--cQ In 101-_ oISS ►l , l � \, a: ' 1 CA " rn Yh O-V C- vv�-5 c? qI oy-+ a v a a. DV DU _ M-s a 2 i► (I ' �' s a: —up C_ ' vti S ai, 11 u r AUTO LICENSE NO. TOTALS oil I + 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 foregoinl3 account is just and correct,that the amount claimed is le al ueraf 'o < end that no part of the same has been paid. Date I I I��I� PRESCRIBED BY STATE BOARD OF ACCOUNTS MILEAGE CLAIM TO City of Carmel, Indiana (GOVERNMENTAL UNIT) 434-3004' FOR Mileage ON ACCOUNT OF APPROPRIATION NO. Department of Law - 1180 (OFFICE,BOARD,DEPARTMENT OR INSTITUTION) SPEEDOMETER At DATE FROM TO READING + NATURE OF BUSINESS MI 20-i-IeL POINT POINT START FINISH TRAI 1 o I 1 t% 1� 1 i \\ 2�Y I CC'✓1�'CJ1D�'�-e� � 1,3 1► 1 0. C a`. a ; Ir CJLCJ-i r,-,S l 1i S C1, c_ fA-` S i t 15 l vaP. 2' A e � S 1• 1' til D \I 11 `� I1 i i �Aq N} AUTO LICENSE NO. TOTALS �7J� + 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 claime 1 du after allow' -end that no part of the same has been paid. Date I