HomeMy WebLinkAbout191689 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
ONE CIVIC SQUARE CHARLES A IMAN CHECK AMOUNT: $45.50
CARMEL, INDIANA 46032 11018 TAM 0 SHANTER DR
CARMEL IN 46032 CHECK NUMBER: 191689
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 45.50 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCousn GENERAL -TORY NG. 101 11 YB61
MILEAGE CLAIM
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t_ F TO
(OOVERNNENTAL UN117
ON ACCOUNT OR APPROPRIATION NO FOR
tOMCE, BOARD, DEFART1.aXT OR INSMIMON)
SPEEDOMETER
DATE FROM TO I READING AAUTO t1IIZAGE C
POINT POINT START FINISH NATURE OF BUSINESS TRAVELM
PER MILE
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3 A Ao A j6A 1
6
�5 r, Y ILA I
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I
AUTO LICENSE NO. TOTALS
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 185, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claim215 legally of i wing all just credits r
end that no part of he a_me has been paid. I i
Date
OCT 2 0 2010
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.
361054 Iman, Charles Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1011110 Reimb Mileage 912 9/30/10 45.50
Total 45.50
I 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
45.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NQ ACCT #[TITLE AMOUNT Board Members
Dept
1081-3 Reimb 4343000 45.50 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
4 -Nov 2010
Signature
45.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
f