HomeMy WebLinkAbout193220 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1
0 ONE CIVIC SQUARE VALESKA SIMMONDS
CARMEL, INDIANA 46032 2703 E LYNN ST CHECK AMOUNT: $140.50
ANDERSON IN 46016 CHECK NUMBER: 193220
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 140.50 TRAVEL FEES EXPENSE
PRB5CRIBLD BY STATL BOARD OF ACCOUNTS C;"F;IAL FOAL tIC. 101 11986)
MILEAGE CLAIM SlCa
TO
(povEINM[NrAL UNn7
ON ACCOUNT OF APPROPRIATION NO. FOR
tOF7[Cf_ BOARD. D"&RTUXWT OR IXSTIT{f Iopq
SPEEDOMETER
2 DATE FROM TO I READING AUTO MILEAGE
a POINT POINT START FINISH NATURE OF BUSINES5 TRAVELED r
PER MILE
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11 MCI Foc
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2 0
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AUTO LICENSE NO. TOTALS 1 �l 1
SPEEDOMETER READING columns are to he used only when distance between points cannot be determined by fixed mileage or official highway map. 5, 59
r
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 1 ally due, after allowing a !just credits,
and that no pa of the sa a has been paid.
Date L..
I
1
PRESCRIBED By STATE BOARD OF ACCOUNTS GENT.BAL fOR11 )eO. 104 um)
MILEAGE CLAIM
TO 3
(GOVERNMENTAL UNITE
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DEPARTWUX? OR IN3TRTn10N)
FROM TO SPEEDOMETER ,AUTO t17LEAGf
GATE BEADING
POINT POINT STAR 7 FINFSH NATUiiE OF BUSINESS TRA EELED
PER MILE
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i r% V"CL IKE 2 11
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i PALC—
iLLNW Cz r0c sir
AUTO LICENSE NO- TOTALS I
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or Official highway map. Li F
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby testify that the foregoing account is just and correct, that the amount claimed is legally due, alter alicwing all hst credits
end that pa of the same has been paid. i
Date
PRLSCRIR[O BY STATE BOARD OF ACCOUNTS
GENERAL iDRL leC. 1�4 114x6)
MILEAGE CLAIM f
TO
(OOVERNNENTAL UNIT]
ON ACCOUNT OF APPROPRIATION NO. FOR
(O"CE, BOARD, DERARTI[EKT OR 1 SL'IJON)
DATE FROM TO E SHiADING TFR AUTO MILEAGE C
26 POINT POINT START FINISH NATURE OF BUSINESS IT,�L D CS
PER MILE
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y 1 1
E I
CG
1
L
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A,
ma—
AUTO LICENSE NO. TOTALS
t SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. f-) 1�
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is inst and correct, that the amount claimed is legally e, after aliowing all ius credits
rnd That np,.g�erl of the same has been paid.
Date
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
12/10/10 Reimb Milea a 10/25 12/10/10 140.50
Total 140.50
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.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of
140,50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -4 Reimb 4343000 140.50 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
16 -Dec 2010
4
Signature
140.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund