HomeMy WebLinkAbout184889 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 360181 Page 1 of 1
ONE CIVIC SQUARE KATHERINE PETSO CHECK AMOUNT: $7.20
CARMEL, INDIANA 46032 P O BOX 921
CARMEL IN 46082 CHECK NUMBER: 184889
CHECK DATE: 4127/2010
DEP ARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 7.20 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENS.RAL FORM 110. 101 (INS))
MILEAGE CLAIM
?acy -s
(GOVERNMENTAL UNIT}
ON ACCOUNT OF APPROPRIATION NO. FOR
DARD, DEF'.." OR INST.10N)
SPEEDOMETER
DAT£ FROM TO READING AUTO UrLE AGE
Zd POINT POINT START FINISi{ NATURE OF BUSINESfi TRAVELED EILES a ED0
PER MILE
1 1
AUTO LICENSE NO-TOTALS
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits
rnd that no part of the same has been paid.
Date
a
`m �0 APR P 4 2010
L 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, ratesper day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
360181 Petso, Kathy Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4114/10 Reimb Mileage 3129110 7.20
Total 7.20
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.
360181 Petso, Kathy Allowed 20
In Sum of
7.20
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE N0. ACCT #MTLE AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 7.20 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
L�
Signature
7.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund