HomeMy WebLinkAbout193988 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 365041 Page 1 of 1
ONE CIVIC SQUARE SIREEN ZAYED
0 CHECK AMOUNT: $11.00
CARMEL, INDIANA 46032
CHECK NUMBER: 193988
CHECK DATE: 1/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 11.00 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GW..RAL FOAM 110- 101 119853
MILEAGE CLAIM j (Q e �Ye c�
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION ND. FOR
(OFFICE, BOARD. DEPARTMENT OR INSnTUT10N)
SPEEDOMETER
DA,TE FROM TO READING NATURE OF BUSINESS A I.IILES Q r
�d POINT POINT START FINISH ('RAVELED PER MILE
12 IV
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 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits r
end that no part of the same has been paid,
Date 17 12� i Z10
J AN 0 5 1011
Y Pte
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.
Zayed, Sireen Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/29110 Reimb Mileage 12/29/10 11.00
Total 11.00
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.
Zayed, Sireen Allowed 20
In Sum of
11.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE N0. ACCT #fTITLE AMOUNT Board Members
Dept
1081 -99 Reimb 4343000 11.00 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
1
Signature
11.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund