HomeMy WebLinkAbout190470 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1
ONE CIVIC SQUARE VALESKA SIMMONDS
0 CHECK AMOUNT: $120.60
CARMEL, INDIANA 46032 2703 E LYNN ST
ANDERSON IN 46016 CHECK NUMBER: 190470
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 69.00 TRAVEL FEES EXPENSE
1082 4343000 51.60 TRAVEL FEES EXPENSE
PRLSCRIBED SY STATE ROARr7 OF ACCOUNTS GFINERAL FOR7d IIO. 101 119867
MILEAGE CLAIM �P
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFi7cr BOARD. DU"TMENT OR 7NsrRI lc"
DATE FROM TO BEAD M ER AUTO MILEAGE
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ZQ NATURE OF BUSINESS 0 POINT POINT START FINISH TRAVELED ED C
PER bSILE
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AUTO LICENSE NO, TOTALS 50
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 51
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 ue, after aliowing all j credits
end that 7art of the same has been paid.
Date U kuf�y�
't D Jt
v
SEA' 1 5 1010
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PRCSCRIBCD BY STATE BOARD OF ACCOUNTS GENERAL FOAL NG, 101 0M)
MILEAGE CLAIM
TO
[GOVERNMENTAL DM
ON ACCOUNT OF APPROPRIATION NO. FOR
LOMCE. BOARD. DEPARTMENT OB INST=109)
SPEEDOMETER AUTO !MILEAGE
DATE FROM TO READING i NATURE OF BUSINESS MILES
Z° POINT POINT START FINISH TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS
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J t),,�'� f t� j ust SPE EDOMETER READING columns are to he used only when distance between points cannot he determined by fixed mileage or official highway map. r(�1 1 Pursuant tD 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, aft lio dits
end that no rl of the same has been paid.
Date
69
jai
v �L SEP 15 ZU1Q
1
ICY...
PRESCRIBED BY STATr BOARD Or AOCOUNTS GENFRAI FORM 11C, 101 11"M
ro
MILEAGE CLAIM U rat ct
J
(GOVERNMENTAL U14111
ON ACCOUNT OF APPROPRIASION NO. FOR
tOF. BOARD, UFPARr.CEN r Oft 1N9TTTUTION)
FROM TO f- SPEEDOMETER AU TO MILEAGE
PATE BEADING i.
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER NILE
t
Y. M
�Z
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certily that the foregoing account is just and correct, that the amount claimed is le a11y a, after allowing all I credits
end that o part of the same has been paid.
Date
SEP
5 2010
I
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.
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
913110 Reimb Mileage 711 8/9/10 51.60
9/3/10 Reimb Mileage 8111 8/26110 42.00
9/3/10 Reimb Mileage 8/27 9/3/10 27.00
Total 120.60
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
I
Voucher No, Warrant No.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of
120.60
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -1 Reimb 4343000 51.60 1 hereby certify that the attached invoice(s), or
1081 -4 Reimb 4343000 42.00 bill(s) Is (are) true and correct and that the
1081 -4 Reimb 43430 27.00 materials or services itemized thereon for
which charge is made were ordered and
received except
23 -Sep 2010
A� 1)
Signature
120.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund