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HomeMy WebLinkAbout333337 12/11/18 yu'��`'' CITY OF CARMEL, INDIANA VENDOR: 359285 ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $********54.50* 9� CARMEL, INDIANA 46032 2703 E LYNN ST CHECK NUMBER: 333337 M�TON��o, ANDERSON IN 46016 CHECK DATE: 12/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 54.50 TRAVEL FEES & EXPENSE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 359285 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Simmonds, Valeska Payee 2703 E Lynn St Anderson, IN 46016 In Sum of$ Purchase Order# 359285 Simmonds,Valeska Terms $ 54.50 2703 E Lynn St Date Due Anderson, IN 46016 ON ACCOUNT OF APPROPRIATION FOR 108-ESE Fund PO#ornvolce Description Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-4 Reimb 4343000 $ 54.50 Board Members 12/3/18 Reimb Mileage 11/5-11/30/18 $ 54.50 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 $ 54.50 Total $ 54.50 December 4,2018 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 20_Accounts Payable Coordinator Clerk-Treasurer Title -Wev 9fck` -T YN /-[(o©A(o PRESCRIBED BY STATE BOARD OF ACCOUM GMERAL FORM NO.101(1906) MILEAGE CLAIM TO 1 Ci b 6 �T( n In C (-NMENFAL URIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE,BOARD,DEPAR OR ULSTRUTION) ATL FROM TO SPEEDOMETER READING + AUTO MILEAGE POINT POINT START FINISH NATURE OF BUSINESS MILES ® q _ TRAVELED PER mns EQ 11-S d G CC, 3 � I t `[ V" f 3 I - - e 11-9 1M tL r Wa - 1 u. 1- W 1-IrviL tl LkL 1-L t . T - m _ u. p -2 \ 3o LL AW c,Cr VVI kJJ Lu�� (— r J AUTO LICENSE NO. TOTALS i Q��}, + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. LI I J� 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 j st credits; end that no part of t le sa has been paid. Data--a1 ,� 17,'U,:- o � Li FDEC03.................. ....