HomeMy WebLinkAbout184836 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 364002 Page 1 of 1
ONE CIVIC SQUARE ASHLEY LIVINGSTON CHECK AMOUNT: $87.50
CARMEL, INDIANA 46032 3404 WOODFRONT PLACE
•''4io� r INDIANAPOLIS IN 46222 CHECK NUMBER: 184836
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 87.50 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE ROARS OF ACCOUNTS GENERAL FORM Na. ICI (1%6)
1� ��►'1� MILEAGE CLAIM
TO
F7 �E 3N K AL UNIT) ON ACCOUNT OF APPROPRIA ION NO. FOR
(oMcE, BOARD, DEPARn32Tr aR INBTrrITT10N)
SPEEDOMETER
.7 DATE FROM TO I READING �OOF S A UTO
MILE S Ca
F-b O POINT POINT START FINrSH TRAVELED
PER MILE
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AUTO LICENSE NO- TOTALS 1 f tlb 1/
f SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway. map 7
Pursuant to the provisions and penalties Of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits,-
and that no part of the same has been paid.
Date
APR 4 4 24i0
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
364002 Livingston, Ashley Terms
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
4114110 Reimb Mileage 311 -411/10
87.50
Total 87.50
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant. No.
364002 Livingston, Ashley Allowed 20
In Sum of$
87.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #fTlTLE AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 87.50 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
87.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund