HomeMy WebLinkAbout194090 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 363864 Page 1 of 1
ONE CIVIC SQUARE JASON ANDERSON CHECK AMOUNT: $14.20
CARMEL, INDIANA 46032 617 N MAIN ST
TIPTON IN 46072
CHECK NUMBER: 194090
CHECK DATE: 2/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 14.20 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 OHS)
MILEAGE CL
ro
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO_ FOR
tOFPICE, BOARD, DEPARTMENT OR INSTTIVIION)
DATE
SPEEDOMETER
FROM TO READING AUTO FFER NATU RE OF BUSINESS 2V 14L POINT POINT START FINISH TRK
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9 1 L; r
i r r ;A)p i
i J I-
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i
C o t o
1- ibr oc v IMT o
T Tr
AUTO LICENSE NO. I I f
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 correcf, that the amount claimed is legally due, afte liow' ust credits
end that no part of tyre same has been paid.
Date Win, 3 :2at1
VV A
L, JAN 0 7 2011
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.
363864 Anderson, Jason Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/3/11 Reimb, Mileage 10/28 12/16/10 14.20
Total 14.20
f 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.
363864 Anderson, Jason Allowed 20
In Sum of
14.20
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT 4MTLE AMOUNT Board Members
Dept
1081 -5 Reimb. 4343000 14.20 I 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
27 -Jan 2011
Signature
14.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund