HomeMy WebLinkAbout189410 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 355569 Page 1 of 1
ONE CIVIC SQUARE JESSICA KRUSE CHECK AMOUNT: $57.23
CARMEL, INDIANA 46032 840 BENNETT COURT
CARMEL IN 46032 CHECK NUMBER: 189410
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4343004 57.23 TRAVEL PER DIEMS
:r
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO S" co, 4 use- :SqO 6enacq C I ---rpj y1�'
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO S READ NGET +R AUTO MILEAGE
ZO NATURE OF BUSINESS POINT POINT START FINISH TRAVELED Q
PER MILE
a S 0 dv
l J ILL P 0 tc1' a 5
L4 q
An
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to
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L� Z e l, 0 J V
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AUTO LICENSE NO. TOTALS /a 75
SPEEDOMETER READING columns are to be used only when distance _between points cannot be determined by fixed mileaqe 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
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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Allowed 19 m a 0 a
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in the sum of ro
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(Board or Commission) o o
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A.E. ROYCE CO_, INC. MUNCIE, IN 01136 M Q+
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986),
MILEAGE CLAIM
TO S y n CJ1 US an rl
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READING SPEED OM E TER AUTO MILEAGE
NATURE OF BUSINESS MILES Q e
a POINT POINT START FINISH TRAVELED PER MILE
U
p a ll L4 q
A Il
a C�-
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.
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 aliowin all just credits
and that no part of the same has been paid.
Date �'CU v
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o tr a
a0 a
m m
0 N
CD
a
Allowed 19 n 0 rt
(D n
in the sum of b R•
m
m w t:r
m m
H y•
cD O C
a
C
cz
CD o
(Board or Commission) o
FILED
a m
rt (D t✓
w tD w
m a m
(Official Title) p O
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A.E. SOYCE CO., INC. MUNCIE, IN 01136
V NO. WARRANT NO.
ALLOWED 20
Jessica Kruse
IN SUM OF
840 Bennett Court
Carmel, IN 46032
$57.23
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1160 Mileage Claim 43- 430.04 $9. 1 hereby certify that the attached invoice(s), or
1160 Mileage Claim 43- 430.04 $47.75
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
Monday, August 30, 2010
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts I City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount.
Date Number (or note attached invoice(s) or bill(s))
08/20/10 Mileage Claim $9.48
08/20/10 Mileage Claim $47.75
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