HomeMy WebLinkAbout333727 12/19/18 4y pt_CAq�f CITY OF CARMEL, INDIANA VENDOR: 373014
cl• ONE CIVIC SQUARE DANIEL KEIM CHECK AMOUNT: $********24.85*
9� j�; CARMEL, INDIANA 46032 9410 CARLYLE DRIVE CHECK NUMBER: 333727
M,�TON�o• APT A CHECK DATE: 12/19/18
INDIANAPOLIS IN 46240
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 24.85 TRAVEL FEES & EXPENSE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 20 I H Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Kelm, Daniel �cJJ 1—[ Payee
9410 Carlyle Drive,Apt.A
Indianapolis, IN 46240 In Sum of$ Purchase Order#
Kelm, Daniel Terms
$ 24.85 9410 Carlyle Drive,Apt.A Date Due
Indianapolis, IN 46240
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#ornvolce Description
Dept# INVOICE NO. ACCT#lrITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-5 Reimb 4343000 $ 24.85 Board Members 12/11/18 Reimb Mileage 10/15-11/29/18 $ 24.85
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
$ 24.85 Total $ 24.85
January 9,2018
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 1pkjvjl�IJ
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
`SLI 10 Corivie Pri've A
DEC 1 1 2010 �
BY:
GENERAL FORM No Al 117M
I'MCMIED HT STATE HOARD OF ACCOUNTS
AIM
MILEAGE CL
CA
la t, 0 ('wl
——T t vEAN ENtmm n ON ACCOUNT OF APPROPRIATION NO. FOR —
�trmeC C6ZV �arrAukS and AereriVo,h
' - tOMCE.BOARD,DW"TI@tr OB 1"b"I UxJUnJ .�
FROM A ;SPEEDOMETER
TO _ I^ READING + ANTLER Cp , s c
DA _ NATURE OF BUSINESS
Za PONT START FINISH TRAVELED PER MILE
POINT _
1
A.
L kaLD a ►._ �
6 !; rC�st f lek`
�9 1 6h.a,,.h — r s c•a �.�e LaF-1- 714
r 4 � t
--- — r w +o M7 a' Ale i✓ 7
r
k rAr�g of Ce 4e, ii�A syr K+ i
0
ov _
dV 0 r ' civ ro _ M
(z ,y m vt "Gt j
ov OD— r�ci,
9� G k - — I
rry l pc. roc y S n
p v o h Trti l Ftcn 1'cis+ _-- 5 3 I 7
i Cctikil'to7
ev q "' ew
Lq
TOTALS
AUTO LICENSE NO.
+ 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 dua, filer alio`ving all)usl credits.
end that no art of t e same has been paid.
Date
�n/1 ev A i -C'V�
V/