HomeMy WebLinkAbout194318 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $68.15
s �?o CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
q:,, INDIANAPOLIS IN 46208 CHECK NUMBER: 194318
CHECK DATE: 2/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 68.15 TRAVEL FEES EXPENSE
PRESCRIEED BY STATE BOARD OF ACCOUNTS GENERAL FORM PO. ICI 11986)
MILEAGE CLAIMT� PEe DI EM �1 -11 4
lmyLL2tcjil�l TO
(GOVERNMENTAL IDnTI ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPART XKr O INyrfrunON)
DATE
FROM TO SPEEDOMETER
READING tNILL•�EE AUTO AG
POINT POINT STAR7 FINISA NATURE OF BUSINESS TRA a ED C
PER M3LE
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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. C2W2) TOTAL �8
Purs nt to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct. that the amount claimed 's 1 ly d e, ter allowing all just credits,-
and th t part of the same has been paid.
Date
r�
JAN 1 .1 2011
GEXF.A FCAW NG. 101 (INS)
PAlSCRISED 11T STATC sOARn Of AC OVNTS
MILEAGE CLAIM
TO TRA VE L PEe DiE tvl 1 -11 434 30D�-
toovETIxNE�+rAE vxlr7 ii ON ACCOUNT OF APPROPRIATION NO. FOR KC��SFaA IT`TM
(OT7CP, a—IRD, UEr"TWr OR INSTYTUTIOX)
FROM TO I SPEEDOMETER AUTO urt v AGE
DATE READING NATURE OF BUSINM I MI1ES
7 POINT POINT START FINISH I- RAVELED PER miu
�{N�Cri I
i-ADWOVA O 1.
b
hie F Wj..ra 3'
N yr 1 1t a
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avLtli Z3 M c t °tX? CC'D R�o� tie Cori C�'� i O FO
JAN
L ti10ti Lit~ R PA t a o
AUTO LICENSE NO. TOTALS
8 M I
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pu suant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is 1te allowing all just credits
end the no parr of the same has been paid.
to
f
JAN 201
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMFL
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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
116111 Reimb Mileage 1111 12/21/10 68.15
Total 68.15
k 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
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
68.15
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -11 Reimb 4343000 68.15 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
68.15 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund