HomeMy WebLinkAbout194352 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
0 ONE CIVIC SQUARE DENEYSE SOLAZZO
CARMEL, INDIANA 46032 14151 PEPIN PLACE CHECK AMOUNT: $82.50
CARMEL IN asasz CHECK NUMBER: 194352
CHECK DATE: 213/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1081 4343000 82.50 TRAVEL FEES EXPENSE
PBBSCRIBED BY STATL BOARD OF AOCOUNTS GENERAL FORM NO. 101 USES)
MILEAGE CLAIM
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(GOVERNMENTAL UNL'n
ON ACCOUNT OF APPROPRIATION NO. FOR
LOFFICB, BOARD, DEPARTKEKT OB INSTn UI1ON)
SPEEDOMETER
DATE FROM TO READING AUTO F� n! GE C
—j t POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
12 1 FALL
L 20 MLC.
12- 20 CALL r 1,ir r
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AUTO LICENSE NO.
TOTALSr�
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 7074z- -r '92 e O
Pursuant 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 Iegally due, after allowing all just credits
end that no part of same has been paid.
Date
t I
i
J AN 0 7 2011
TT
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL -FORM 110. J01 11906)
MILEAGE CLAIM
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO- FOR
(OFFICE, BOARD. DEPARTMENT OR INSTMJ7109)
SPEEDOMETER AUTO )AIL2 E
DA,TE FROM TO V READING NATURE OF BUSINESS MILES c
IV POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS 1 j fl $('s
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 7
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.
Dale 2-1 (i a no�
1 ,SAN 0 7 2011
Pp
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.
364715 Solazzo, Deneyse Terms
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12122110 Reimb Mileage 11/15 12/22/10 82'50
Total 82.50
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.
364715 Solazzo, Deneyse Allowed 20
14151 Pepin PI
Carmel, IN 46032
In Sum of
82.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. 4CCT #/TITLE AMOUNT Board Members
Dept
1081 -9 Reimb 4343000 82.50 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
82.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund