HomeMy WebLinkAbout182391 02/17/2010 a F CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
ONE CIVIC SQUARE CHARLES A IMAN CHECK AMOUNT: $26.95
y/ CARMEL, INDIANA 46032 11018 TAM O SHANTER DR
CARMEL IN 46032
CHECK NUMBER: 182391
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 26.95 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNM
ON ACCOUNT OF APPROPRIATION NO. FOR
(OMGE� BOARD, DEPARTMENT OR INSTITUT
DATE FROM TO SPEEDOMETER AUTO MILEAGE
READING
19 POD POINT START FINISH NATURE OF BUSINESS TRA LED
PER MILE
�G G, Me r fk7 G
a
o
L1 1 17 1
f
0
AUTO, LICENSE NO. TOTALS �q5
SPEED OMETER"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 penaltie's of Chapter 155, Acts 1953, I hereby certify that the fore omg account is just and correct, that the amount claimed is legall ue, a a g all just credits,
.end that no p A of the same has been paid. —y
Da #e
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.
361054 Iman, Charles Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1119/10 Reimb. Mileage 12/9 12/17/09 2.6.95
Total 26.95
1 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
i
Voucher No. Warrant No.
Iman, Charles Allowed 20
361054
In Sum of
26.95
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#fTITLE AMOUNT Board Members
Dept
1081 -3 Reimb. 4343000 26.95 1 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
11 -Feb 2010
Signature
2655 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund