HomeMy WebLinkAbout189836 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
0 ONE CIVIC SQUARE CHARLES A IMAN CHECK AMOUNT: $52.50
CARMEL, INDIANA 46032 11018 TAM 0 SHANTER DR
CARMEL IN 46032 CHECK NUMBER: 189836
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 52.50 TRAVEL FEES EXPENSE
PMCRIBED BY STATE BOARD OF AOCOUNT5 GENT,RAL -FORM 7 +0. FIB) (1985)
MILEAGE CLAIM Ki
(GOVERNMENTAL UNM ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMD]fT OB INSTMMON)
SPEEDOMETER
DATE FROM To I READING AUTO MILE NATURE OF BUSINESS Ulm
POINT POitiT START FINISH TRAt1£L60 PER MILE
10
4 o
AUTO LICENSE NO- TOTAL
S -PEEDOMETER 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 i gall du tow" g all just credits
and that no part 4 th same has been paid.
late
SEP 0 7 2010
1 Y6
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.
361054 Iman, Charles Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
911110 Reimb Mileage 819 8/31/10 52.50
Total 52.50
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.
Iman, Charles Allowed 20
361054
In Sum of
52.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1081 3 Reimb 4343000 52.50 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
9 -Sep 2010
J?& &Zfn;�—
Signature
52.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund