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HomeMy WebLinkAbout194121 02/03/2011 n CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1 �4 0 ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: $66.05 CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE NOBLESVILLE IN 46060 CHECK NUMBER: 194121 CHECK DATE: 2!312011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 66.05 TRAVEL FEES EXPENSE PMCRIRED 137 STATE BOARD OF ACCOUNTS GENRRAI- FORA 110_ ICI (19857 MILEAGE CLAIM (GO9rRNMENTAL UNIT) 1 ON ACCOUNT OF APPROPRIATION NO. FOR (OF BOARD, DETARTI3](T OR INsr=1ON) SPEEDOMETER DATE FROM TO READING MILES c NATURE OF BUSINESS 2b POINT POINT START FINISH TRAVELED P OrN (A o G lQ y l n,t7Cl TTl �-t� a Y0 ,t 4 n 6 1 T m m fL e lay 7 LO PL) 3, ;I- Or\ D'n T L4 I E N rY\ t Li t\ T A-0 3 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. TOTA L ZFa5 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 allowing all just credits end that no p rt of the s m been paid. �/f�D Date !jam JAN 2011 r-7: PRYSCRIBCD BY STATE BOARD OT ACCOUNTS GENERAL FORM NO. 101 (1985) MILEAGE CLAIM TO (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO- FOR (OFFICE., BOARD, DU& AnWMrr OR 1NSn 10?1) SPEF.0OMETER DATE FROM TO V RFJiDtNG AUTO SS MILEAGE ZQ POINT V POINT START FINISH NATURE OF BUSINESS TRAVELED PER MLLE YL T r I 3, i/Yw 3 V= i AUTO LICENSE NO. TOTALS SPEEDOMETER READING columns are to be osed 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 allowing all just credits end that no att of he ame has been paid Dale 4 1 -2. l✓� JAN 2011 L R 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. 360144 Canada, Cyndi Terms 11508 Lucky Dan Dr Noblesville, IN 46060 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 12/30/10 Reimb. Mileage 11117 12130/10 66.05 Total 66.05 1 hereby certify that the attached invoice(s), or bili(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 2 Clerk- Treasurer Voucher No. Warrant No. 360144 Canada, Cyndi Allowed 20 11508 Lucky Dan Dr Noblesville, IN 46060 In Sum of 66.05 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -5 Reimb. 4343000 66.05 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 27 -Jan 2011 Signature 66.05 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund