HomeMy WebLinkAbout181977 02/03/2010 a „N CITY OF CARMEL, INDIANA VENDOR: 363864 Page 1 of 1
ONE CIVIC SQUARE JASON ANDERSON
CARMEL, INDIANA 46032 617 N MAIN ST CHECK AMOUNT: $13.75
T IPTON IN 46072
,,o CHECK NUMBER: 181977
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 13.75 TRAVEL FEES EXPENSE
1
PRESCRIBED BY STATE BOARD OF ACCOUNTS r:ENERAL FORS( NO 101 {1986}
MILEAGE CLAIM 1 1
CLJ I z.." MILEAGE
L JC/I r1 T I A r op a 3 G'v1
T �v �ppoo L uNI'[�
ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE. BOA 0 AAt1(E.IfT OR INSTITUTION)
SPEEDOMETER
2
D r FROM TO READING AUTO MILEAGE
!1 NATURE OF BUSINESS MILES
POINT POINT I START FINISH TRAVELED n
PER MILE
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AL Marell MIIIERPENCIMOMINIMINIMERIMININII
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AUTO LICENSE NO. TOTALS i
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. p()
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 a st credits
end that no part of the same has been paid.
l
Date t,— L F`;
Llko I 0 0 0 05 ITSLI3 IV NI \ki 0 7 2010
?tik.., cy
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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.
Anderson, Jason Terms
I nvoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/4/10 Reimb. Mileage 12/16 12/21/09 13.75
Total 13.75
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.
Anderson, Jason Allowed 20
In Sum of
13.75
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1081 -5 Reimb. 4343000 13.75 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
28 -Jan 2010
Signature
13.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund