HomeMy WebLinkAbout181129 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1 ONE CIVIC SQUARE TIFFANY BUCKINGHAM
1i CARMEL, INDIANA 46032 5130 PRIMROSE AVE CHECK AMOUNT: $190.85
INDIANAPOLIS IN 46205 CHECK NUMBER: 181129
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 190.85 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 GRES)
MILEAGE CLAIM
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(GOV'EPNMENT: A 11Tt
S ON ACCOUNT OF APPROPRIATION NO. FOR
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(OFFICE. BOARD ART/47N7 OR INSTITUTION)
SPEEDOMETER i
FROM TO 1 AUTO MILEAGE
DATE READING -J
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POINT
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PER MILE
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AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due "(ter allowing all just credits
and that no pars of the same has been paid.
Date
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/21/09 Reimb. Mileage 10/8 12/21/09 190.85
Total 190.85
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
fflgter In Sum of$
190.85
ON ACCOUNT OF APPROPRIATION FOR
d
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1446 Reimb. 4343004 190.85 I hereby certify that the attached invoice(s), or
f o5 f --a 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
7 -Jan 2010
Signature
190.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund