HomeMy WebLinkAbout194752 02/16/2011 =9� CITY OF CARMEL, INDIANA VENDOR: 364943 Page 1 of 1
ONE CIVIC SQUARE VICKI RUBIO CHECK AMOUNT: $77.83
CARMEL, INDIANA 46032
CHECK NUMBER: 194752
CHECK DATE: 2/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DE
1081 4343000 77.83 TRAVEL FEES EXPENSE
I I
PRFSCRIBEP BY STATE ROAAn Or ACCO111775
GFXFR AL -FORM 110. 101 119867
MILEAGE CL f'!. r�
I
(GOVERNMENTAL 61NM ON ACCOUNT OF APPROPRIATION NO. FOR
LPi:ICY, HOARV. 47EPARTMEIfT OR 1K3rMJr1CW)
SP EEDOMETER
D FROM TO I READING AUTO MILEAGE
POINT POINT START FINISH NATURE OF BUSINESS TRAVELS d
ED
PER 1dII:E VI
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7011 I (.crc G
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11 IV 1 l' t!° ti
il'-aq 9D i D O a
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V-42 P t i);Ioii C
Al1T0 LICENSE NO, TOTALS C
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 iusl and correct, that the amount claimed is -leg rz f teer ing all iust credits
end that no part g of the same has been paid. Date �LJ
JAS! 3 1 20
11 D
�y.
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
364943 Rubio, Vicki
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
77.83
1128111 Reimb Mileage 12/22/10 1128111
Total 77.83
I hereby certify that the attached invoice(s), or b6l(s) is (are) true and correct and I have audited same in accordance
with IC 6- 11- 10 -1.6
20_
Clerk Treasurer
Voucher No. Warrant No,
364943 Rubio, Vicki Allowed 20
In Sum of
77.83
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1081 -3 Reimb 4343000 77.83 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
10 -Feb 2011
Signature
77.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund