HomeMy WebLinkAbout184239 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 359554 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL ETHRIDGE CHECK AMOUNT: $128.00
CARMEL, INDIANA 46032 8821 GANTON COURT
INDIANAPOLIS IN 46234 CHECK NUMBER: 184239
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 128.00 TRAVEL FEES EXPENSE
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T.
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENFRAL FOR4 NG. 101 114867
MILEAGE CLAIM TRME L D1 EM
(GOVERNMENTA
ON ACCOUNT OF APPROPRIATION NO. FOR
13 Cr BOARD, PE+ARTZRT OR INSrrrUTioN)
FROM TO SPEEDOMETER AUTO uR V E
DATE READING f- J j
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PEA MILE
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AUTO LICENSE NO. TOTALS
jr 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 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.
Date L�
1
PEAR 2 4 2010
BY
�Q
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.
359554 Ethridge, Crystal Terms
8821 Ganton Ct
Indianapolis, IN 46234
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3118110 Reimb. Mileage 213 3118110 128.00
Total 128.00
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.
359554 Ethridge, Crystal Allowed 20
8821 Ganton Ct
Indianapolis, IN 46234
In Sum of
128.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE N0. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -10 Reimb. 4343000 128.00 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
8 -Apr 2010
Signature
128.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
t