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HomeMy WebLinkAbout180892 12/30/2009 "1 CITY OF CARMEL, INDIANA VENDOR: 361086 Page 1 of 1 1":41 ONE CIVIC SQUARE JACOB C MOORE CARMEL, INDIANA 46032 348 ATHERTON DR CHECK AMOUNT: $38.61 CARMEL 1N 46032 CHECK NUMBER: 180892 CHECK DATE: 12!3012009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1046 4343004 38.61 TRAVEL PER DIEMS PRESCRIBED BY STATE OAP OF ACCOUNTS GENERAL SO1114 NO. ICI 1966) MILEAGE CLAIM TO_ Yet. (GOVERNMENTAL uxlTt ON ACCOUNT OF APPROPRIATION NO FOR (Or910E, BOARD, DEPARTMENT OR INS/111.1110N) SPEEDOMETER V FROM TO I READING AUTO N •PAGE D POINT I POINT START FINISH NATURE OF BUSINESS TRAVELED Sc PER MILE IP II_ ./r d� .4 Er It ..D 7 e i� zagr. 1i «i=1li�•Elk k VC" IC rialikumi 11111111M11 u j A I I J1 N ii N ii V1 If 6I Ji M I MI II N 11 r u 1 1 17 1 111111 II i I, a f I y I 1r Via 1 L_ 11 ME ff fin J f 2. 5 k i 1 is k l A 1r K I I 12_ M. n N I A AUTO LICENSE NO TOTALS 1'7 "2 v i'8 1 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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, fter allowing all just credits end that no part of the same has been paid. Date I ©d oo1 9 .e"- ?t 0 b' DEC 1 0 2009 f 1/___A\/ t L- ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Purchase Order No. 361086 Moore, Jacob Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 12/4/09 Reimb. Mileage 10/27 12/4/09 38.61 Total 38.61 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. Warrant No. 361086 Moore, Jacob Allowed 20 In Sum of A l 38.61 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or Board Members INVOICE NO. ACCT #ITITLE AMOUNT Dept 1046 Reimb. 4343004 38.61 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 23 -Dec 2009 Signature 38.61 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund