HomeMy WebLinkAbout183726 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 362295 Page 1 of 1
ONE CIVIC SQUARE DAVID BARNES CHECK AMOUNT: $136.00
CARMEL, INDIANA 46032 5634 RIDGE HILL war
AVON IN 46123 CHECK NUMBER: 183726
CHECK DATE: 3129/2010
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 136.00 EXTERNAL 'TRAINING TPA
I
Prescribed by State Board of Accounts General Form No. 101 (1955)
MILEAGE CLAIM
TO DR.
(Governmental Unit)
On Account of Appropriation No. for �Q
(Office, Board, Departmen or Institution)
DATE FROM TO 5 U
ODOMETER READING NATURE OF BUSINESS AUTO MILES MILEAGE
20 Point Point Start i Finish TRAVELED PER MILE
�nJ C C�� (o n l (o [off 73 E� cam''- 00
A ob" (Ob i tk 50 G 3 oCa
J A' .;"d L'C Po 5r_r. I CO 00
3 L7 So �r rrcrt) 3
I
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f
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l
Auto License No. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determ ed by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after
allowing all just credits, and that no part of the same has been paid. d
Dat
Claim No, Warrant No I have examined the within clairn and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently correct
incorrect
On Account of Appropriation No. for
Disbursing Officer
H
n
Allowed 20 (D
o
n
in the sum of o-
(D (D
x
a
QQ
(Bated or Commission)
O
CD
FILED m
in'
o o
(D 0
ch
(Official Title) p
term O
O N a
iPrescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Dave Barnes
Purchase Order No.
Engineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a n/a Mileage from travel to Road School 36.00
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Dave Barn _s IN SUM OF
Engineering Department
$136.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a 22004343002 $136.00 bill(s) is (are) true and correct and that the
n/a materials or services itemized thereon for
which charge is made were ordered and
received except
31Z�o 20
Signature
ei�t C nn�r� 4AY
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund