HomeMy WebLinkAbout194264 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 364002 Page 1 of 1
ONE CIVIC SQUARE ASHLEY LIVINGSTON CHECK AMOUNT: $81.00
CARMEL, INDIANA 46032 3404 WOODFRONT PLACE
INDIANAPOLIS IN 46222 CHECK NUMBER: 194264
CHECK DATE: 2/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 81.00 TRAVEL FEES EXPENSE
PRlSCRIBED By STATE BOARD OF ACCOUNTS SENFAAL FORM NO. IPI (1965)
MILEAGE CLAIM
1�, VERNMFNTAL UNIT) °l-
ON ACCOUNT OF APPRO RIATION NO. FOR
(OFFICE, BOARD, DEPART6EWT OR INSTMJT1QN)
SPEEDOMETER
FROM TO R NATURE OF BUSINESS A UTO Q rl V E c
POINT t POINT START FINISH TRAVELED PER MILE
Q0 I
f -I f
V _r
1 IL a T
j
h
t 4v tD
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 allowing all just credits
end that no part of the same has been paid.
Date
1 P e 7
J AN 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.
Terms
364002 Livingston, Ashley
Invoice invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s))
81.00
12123110 Reimb Mileage 11/29 12123/10
Total 81.00
1 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.
364002 Livingston, Ashley Allowed 20
In Sum of
81.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #rTITLE AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 81.00 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
27 -Jan 2011
Signature
81.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund