HomeMy WebLinkAbout185429 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1
ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $88.00
CARMEL, INDIANA 46032 2703 E LYNN ST
ANDERSON IN 46016 CHECK NUMBER: 185429
CHECK DATE: 5111/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 88.00 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATL BOARD OP ACCOUNTS GENF.PALiORY NG. 101 (19867
MILEAGE CLAIM
TO L
)GOVERNMENTAL UNIT}
ON ACCOUNT OF APPROPRIATION ]JO.. FOR
(O ➢7C>:, HOAAV, vEPAATM2DfT OR INSCTFUrtGN)
§PF.EDOMETER
DATE FROM To READING AUTO GE
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NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELER MILE
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AUTO LICENSE NO. TOTALS
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f SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage.or official highway map. 00
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 legall due, after aliowfng all ju credits 1
and that np part gf0e�sam� been paid,
Date l� 5
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PRESCRIBED BY STATE. BOARD OF ACCOUNTS J GENERAL FORM NO- 10) 119867
MILEAGE CLAIM I eS ro t
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF<ICB, 90AND, DEPARTMENT OR INSnTULION)
SPED
FROM SO READING AUTO taII,EAGE l{'✓
DATE
T NATURE OF BUSINESS MILES (s
POINT POINT START FINISH TRAVELfiD PEA MILE
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AUTO LICENSE NO_ TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage.or official highway map. r�
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 leFt ing all j credits
end that nq p jrt,PI the Same has been paid.
Date L J l l C>
�IAAVY r"
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.
359285 Simmonds, Valeska Terms
2703 E Lynn St Date Due
Anderson, IN 46016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4130110 Reimb. Mileage 3115 4129110 88.00
Total 88.00
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
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of
88.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1081 -4 Reimb. 4343000 88.00 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
5 -May 2010
Signature
88.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I