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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 a i AL Marell MIIIERPENCIMOMINIMINIMERIMININII t M MI IMIIEIMI ME I rei lliiiii =MI IIIIIIIIII 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 4040-- DY:..1 4..Q 6 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