HomeMy WebLinkAbout190662 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER
0 r CHECK AMOUNT: $36.80
la CARMEL, INDIANA 46032 12913 CURRIER STREET
CARMEL IN 46032 CHECK NUMBER: 190662
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 36.80 TRAVEL FEES EXPENSE
PRESCRIBED By STATE BOARD OF ACCOUNTS GENERAL FORM NO, 103 )19047
MILEAGE CLAIM J 3, gh�&
V, L" &I 1 1
TO
(IX3VFRNMEN UNIT)
s ON ACCOUNT OF APPROPRIATION NO- FOR
(OMCE, HOARD, D ARTM�T OR INS ON)
SPEEDOMETER
D TE FROM TO SPEEDOMETER AUTO MILEAGE
AA NATURE OF BUSINESS MILES SO
Zp POINT POINT START FINISH TRAVELED PER MILE
R1�lG iUt ��Ou7f+ S1 I
T
q.
13
6 3:
Dr A mfr 1
11 1
is L y L
G f �C k M I' f`
't OtaC w' I yy
AUTO LICENSE NO. TOTALS t7 0 i
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 legall e, aft B wing all just credits
and 'hat no part of the same has been paid.
Date
To
St' 2 3 1010
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.
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, 1N 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/23/10 Reimb Mileage 1/21 9/22/10 36.80
Total 36.80
I hereby certify that the attached invoice(s), or bills) 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.
359600 Ballinger, Helen Allowed 20
12913 Currier Street
Carmel, IN 46032
In Sum of
36.80
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO #or INVOICE NO. ACCT /TITLE AMOUNT Board Members
Dept
1125 Reimb 4343000 36.80 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
36.80 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund