HomeMy WebLinkAbout190651 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 363864 Page 1 of 1
ONE CIVIC SQUARE JASON ANDERSON
CARMEL, INDIANA 46032 617 N MAIN ST CHECK AMOUNT: $25.25
TIPTON IN 46072 CHECK NUMBER: 190651
CHECK DATE: 10113/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 25.25 TRAVEL FEES EXPENSE
a
FRLSCRIHLO BY STATE HOARD OF ACCOUNTS GENRAAL FOR}t!!O. 101 11988)
MILEAGE CLAIM T
tnovFxNfleNrAluruTi
C ON ACCOUNT OF APPROPRIATION NO. FOR
to'. HOARD, DFSARTKEn OR INSnTLITION)
FROM TO SPEEDOMETER AUTO URZAGE
DATE READING READING
Aa POINT POINT START FINISH NATURE OF SUSINE56 TRAVELED
PER MILE
�c J^
w! JAD 6om #1 I t
V n F{' yY1u/ CS lfl
U 1 j✓ff� Off' i
a:l (Yt
✓rn i o woc
r C.
I
iZ L; of WOC
Ce 1
AUTO LICENSE NO_ TOTALS Lq3 3
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 allowing all just Bits
end that no part of the same has been paid.
Date fy
r4
SEA' 2 8X010
]BY:......................
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENYAAL FORW 1[O. 101 f1496)
MILEAGE CLAIM
6 TO—
E SE (GOVERNMENTAL UNIT}
ON ACCOUNT OF APPROPRIATION NO- FOR
(OFFICE, BOARD, UPARn INT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILEAGE DATE READING
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED r
PER MILE
1
i* w K Tne., 5 tb Wa
T
AUTO LICENSE NO. TOTALS
7,
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 w g just credits
end that no part of the same has been paid.
Date I
rM
JK
r (I
SEP
OIL
k 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.
363864 Anderson, Jason Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bili(s)) PO Amount
9/23110 Reimb, Mileage 8/12 9116110 25.25
Total 25.25
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,
363864 Anderson, Jason Allowed 20
In Sum of$
25.25
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1081 -5 Reimb. 4343000 25.25 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
7 -Oct 2010
Signature
25.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund