HomeMy WebLinkAbout181168 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 360417 Page 1 of 1
i'''ilit ONE CIVIC SQUARE JESSICA DAVIS
CARMEL, INDIANA 46032 CHECK AMOUNT: $55.82
o N CHECK NUMBER: 181168
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 55.82 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD Of ACCOUNTS GENERAL FOBH NG. IN nBBa7
MILEAGE CLAIM
TO TZthge L ?ER- DIEM 46 -100 0 t 1-- 434
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
tOFi10R, BOARD, DEPARTY:Da OR MStTFUrtON)
SPEEDOMETER
DATE
FROM TO READING 4- AUTO MILEAGE f
POINT POINT I :jr TR FINISH NATURE OF BUSINESS TRAVELED
W PER MALE
11 11611 fl�'llfl IMISI ILaireli tilli 1•11M. I��JLiI<���IWN7
17 MEM t. 1 I 1 iiP Pl J n__ i �lr�
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MIMI
NM =11•11=1111M111= =EN
M =11=11= IIIII.
111.1.11 1 I NM
AUTO LICENSE NO. TOTALS 1— 17
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 1957, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing ust cred'
and that no part of the same has been paid,
i 10.E �1. I I�
Date p
i__\ (1-2-) e '‘ki (r7 el rp Tr r".
J
DEC 2 1 1009
Jec t' 6k2D
PAY-SCRIBED HT STATE AOAAD OF ACCOUNTS GEXFAAL FOAM I. 1Q1 (1986]
MILEAGE CLAIM
TO TRAYS I. PER- DIEM 46 1000IL k34 O
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO FOR
(OFT10E, HOARD, DEPAATYISNr OA INS ITVI10N)
DATE FROM TO lI
READING AUTO MILEAGE
NATURE OF BUSINESS MILES q c
POINT POINT I FINISH TRAVELED
PER MILE
�ir ei M mwsiger .%r�1�11J n Ill�ul�lil:�il�Jf� s �1 =IMII�I•�PR I �MIiI
Mill
all EIM 1111.11111.111 I
ill• AP MIIIIIIMINIIIIMIll 1111•11 MN!
IMIIIIIIIIIIII 1 L
MINN
EGA 1 1111111/411•111Y
MI I
1111111111 MINIM =611=11 MI MEM
L.:2=111•111 INIIIMIIINI /1111111111•1•1110 NMI Min
ARMIN= MIMIIIIIIIIIM111.1111•1111111111•1111M1111 MI 11= W
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4 �IA
I�I
AUTO LICENSE NO_ TOTALS 1GI1•Aw
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 foregoin account is just and correct, that the amount claimed is le• fly due, after allowing all j e••
and that no part of the same has been paid. l t 1
Date f�\ej 1, �1�1L1 4 -.73 F-7 T d
n 1 k
D 7 k
it .,y
DEC 2 1 7009 id ETE
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.
360417 Davis, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/21/09 Reimb. Mileage 11/2 12/21/09 55.82
Total 55.82
I hereby certify that the attached invoice(s), or bills) 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.
360417 Davis, Jessica Allowed 20
In Sum of$
55.82
ON ACCOUNT OF APPROPRIATION FOR
nd
la
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
Reimb. 4343004 55.82 I hereby certify that the attached invoice(s), or
101 1) 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
55.82 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund