HomeMy WebLinkAbout194407 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 363871 Page 1 of 1
j k ONE CIVIC SQUARE HALEY WILDRICK
CARMEL, INDIANA 46032 7636 EAST WOODLAWN AVE CHECK AMOUNT: $9.70
INDPLSIN 46239 CHECK NUMBER: 194407
CHECK DATE: 2/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 9.70 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS MILEAGE CLAIM GENMAL FORM 1 +0. 1m A1 986) TO AC2 1 1Q
[GOVERNMENTAL VNIII
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFi1CP, BOARP, PEPARi1fENT OR ENSTTNTIONJ
FROM TO SPEEDOMETER AUTO t11'[�AGE
DATE I HEADING i- —t
10 POINT POINT START FINISH NATURE OF BUSINESS TRAV£ ED
PER MILE
o O r r
ML
Y a Yca-4
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, l hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits
and that no part of the same has been paid.
Date
AN 0
LLB" tl T71 ti
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,
363871 Wildrick, Haley Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount.
113!11 Reimb Mileage 912 12/15/10 9.70
Total 9.70
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.
363871 Wildrick, Haley Allowed 20
In Sum of
9.70
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 9.70 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
9.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund