HomeMy WebLinkAbout180818 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1
ONE CIVIC SQUARE PAMELA GRIFFITHS CHECK AMOUNT: $61.60
4
k CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 180818
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343004 61.60 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
TO_ 1 MILEAGE CLAIM P J S m f t t---
_-__T_VAD (GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READING SPEEDOMETER MILEAGE
NATURE `JJ Q
19 POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS I 5 O irlin
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 -lega due, after allowing all just credits
and that no part of the same has been paid.
Date
is/ 2 T. -%1�
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently I correct
1 incorrect
Disbursing Officer
On Account of Appropriation No. for
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BOYCE CO., INC. MUNCIE, IN OII 6 f�pp
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PRESCRIBED BY STATE BOARD OF ACCOUNTS re_ O GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM P/: ill 6 PI f ,J f 7-/-/
IS/ ADaliN TO. r
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOMETER AUTO MILEAGE a
NATURE OF BUSINESS MILES _5�
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AUTO LICENSE NO. TOTALS I 3"'t o
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. W
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
and that no part of the same has been paid. 4111. R
Date DeCe /97 b f a� g
O
•C�.
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
m c to
y 0 o
Allowed 19_ m n a
n kr x
D' F t P
CD
in the sum of x m
m ij
H 5.
1—
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co II H o
y a
H on
p a. n
n o
(Board or Commission) 6
a
w
FILED a a a
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m m
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(Official Title) O
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A.E. BOYCE CO., ENC. MUNCIE, IN 01136 n
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Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Pam Griffiths Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/21/09 Mileage Reimburssment $61.60
Total $61.60
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.
20
Clerk- Treasurer
VOUCHER NO: 1Z.-*9WARRANT NO.
ALLOWED 20
Pam Griffiths IN SUM OF
12906 Double Eagle Circle
Carmel, IN
$61.60
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1202 Information Systems
Board Members
D Pr INVOICE NO. ACCT #iTITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1202 430 04 $61.60 materials or services itemized thereon for
which charge is made were ordered and
received except
20
n
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund