HomeMy WebLinkAbout184690 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
CHECK AMOUNT: $120.00
INDIANAPOLIS IN 46205 CHECK NUMBER: 184690
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 120.00 TPLAVEL FEES EXPENSE
P"SCRISED BY STATE BOARD Or ACCOUNTS GENERAL FORM i10. ICI (1986)
MILEAGE CLAIM `V
tGOVEF�NM �M3AL UNIT}
!1 ON ACCOUNT OF APPROPRIATION NO- FOR
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SPEEt]OMETER
FROM TO AUTO
DATE READING f IdII SAGE
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AUTO LICENSE HO. TOTALS
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 aliowing all just credits
end that no part of the same has been paid.
`Date
v
APR 42010
j
BY:
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4114110 Reimb. Mileage 2122 3/29/10 120.00
Total 120.00
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.
I
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
120.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1081 -2 Reimb. 4343000 120.00 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
22 -Apr 2010
Signature
120.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund