HomeMy WebLinkAbout189946 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 360181 Page 1 of 1
Q� ONE CIVIC SQUARE KATHERINE PETSO CHECK AMOUNT: $5.70
CARMEL, INDIANA 46032 P 0 BOX 921
'..off da CARMEL IN 46082 CHECK NUMBER: 189946
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 5.70 TRAVEL FEES EXPENSE
GFN"A,L FORM NC. 101 11ceu)
PBBSCRISED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
%7 C—
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
e e
[OFFICE, BOARD. DEF"T)GTFr OR INS =169)
FROM TO SPEEDOMETER AUTO t1fl SAGE
DATE READING NATURE OF BUSINESS MIS r
POINT POINT START FINISH TRAVELED
i
T
AUTO LICENSE NO_ TOTALS I o 11 `l —7D
SPEEDOMETER READING columns are to be used omly 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 9I' ving all just credits
and that no part of the same has been paid.
',late 11�10 I I
1,D q3 1
99 D amRv
A UG 2 5 2910
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, rates per 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
8120110 Reimb Mileage 4127110 5,70
Total 5.70
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
5.70
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO #or INVOICE NO. ACCT #/TITt AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 5.70 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
Signature
5.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund