HomeMy WebLinkAbout193787 01/19/2011 aka, CITY OF CARMEL, INDIANA VENDOR: 360925 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HOLDER CHECK AMOUNT: $132.58
CARMEL, INDIANA 46032 5716 DURHAM CASTLE CT APT 137
NDPLS IN 46250 CHECK NUMBER: 193787
CHECK DATE: 111912011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 132.58 TRAVEL FEES EXPENSE
PBESCRTBED BY STATE BCAn OF ACCOUNTS
MILEAGE CLAIM
TO
c' cy
�ovsR ENrA ut r> ON ACCOUNT OF APPROPRIATION NO. FOR
r r C 1
BOARD, DEPARTMENT OR AS:YIUMON)
FROt✓ TO ME
SPEEDOTER
DATE READSNG I AUTO MILEAGE
yy�� NATURE OF BUSINESS MILES 5c; a
POINT POINT START FINISH TRAVELED PER MILE
V"Ac Z
a I tt 11 I
rive 1 C R
II 0IN I r. °5
1 1 II 1 7 S
II I ��x: C� $5
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AUTO LICENSE NO. TOTALS
SPEEDONETER READING columns are to be used cmy when distance between points cannot be determinad by Eyed -n'_leage cr o::icial lnig v:ay =ap.
Pursuant o the provisions and penalties e; Chapier 155, Acts 1053, I hereay cent iy that the foregoing accouni is jest and correct, that the amo :at claimed is legally d alter allowing all just etedits
end that no pars o: he same has been paid.
Date 1 aAc
1U r
r
JAN 0 3 2011
n7r:
OF mlWU3 A OP �c6 a black vesuV gin kv- �AN-af dente. -�co -kw
PRESCRtEED BY SV T1'E BOARD OF ACCOUNTS
MILEAGE CLAIM r
To
CC�
((3OFENNMENTAL UNIT) ON ACCOUNT OF APPk)PRIATION NO, FOR
(OFFICE, BOAP.n, DEPAMMENT OR wsT1T=1Oh)
SPEEDOMETER
DATE FROM. TO READING AUTO MILEAGE
POINT POINT I START FINISH NATURE. OF BUSINESS T A ILES SD m
PEP MILE
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c, I C1� r `r�a,var� i II I
.AUTO LICENSE NO TOTALS
SPEEDOMETER READING columns are to be used emy when distance between points cannot be determined by fixed rileage or efficial :highway map.
Pursuant to the previsions and penalties of Chapter 155, Acts 1053, I hereby cer ify that tine foregoing account is just and correct, that tae amount claimed is legally due, after alioarng all just credits
enC that no part of the s -are has been pain.
Da'e
JAN 0 3
pM5CRFBED BY STATE BOARn OF ACCOUh73
MILEAGE CLAIM
TO c L
(GOVERNMENTAL UNT) ON ACCOUNT OF APP.iOPRIATiON NO, FOR
(OFF BOARD, DEFARTMEVT CR U;5V LION)
1 SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS MI O AGE
19 POINT POINT i START FINIS TRAVELED PER MILE
�1V G
I II S S'
1 C 2W 1 11
I evcrU 1 I` cp S
II ors C ,�i I I I e II I I
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AUTO LICENSE NO, TOTALS E
y SPEEDOMETER READLNG columns are to be used only when cistance between points caa:_ct be determined by fixed mileage or official highway map. i
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, l hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, ai`:er allowing all just credits
end that no part of the same has been Pala.
Date �`C� 10/ 10 o
j
L. JAN 0
E 7
PRESCRIBED BY S7ATE POA.FZ OF ACCOUN75
�anool
MILEP.GE CLAIM 1 V)Y) j
cc \z 1 P 4Jf
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPEOPRIATION NO. FOR
(CFFECE, BOAP. DEPARTMENT OR INSTIIU:ICN)
FROM TO SPEEDOMETER AU ?O MILEAGE
DATE READING
NATURE OF BUS INESS MILES a 51z,- a
PO ?NT. POINT START FINISH TRAVELED pEA MILE
I
Uti]U N c
i I C
II 0 Off) C I —1 11 SS
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AUTO LICENSE NO. TOTALS �5 All 132 I CJg
SPELDQMETER READING columns are to be used only when distance beivreen points cannot be determined by fixed nileage or official highwav map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that tae foregoing accou=nt is just and correct, that the amour t clai nee is legally cue, after alio,ti ng all just osedits
zad that no part of the same has been paid. t
Date A«/ c
JAN 0 3 2011
4
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.
360925 Holder, Jennifer Terms
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
132.58
12/10/10 Reimb Mileage 716 11/30/10
Total 132.58
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.
360925 Holder, Jennifer Allowed 20
In Sum of
132.58
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #J7ITLE AMOUNT Board Members
Dept
1081 -6 Reimb 4343000 132.58 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
13 -Jan 2011
Signature
132.58 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund