HomeMy WebLinkAbout195363 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
CHECK AMOUNT: $129.28
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
NOBLESVILLE IN 46060
CHECK NUMBER: 195363
CHECK DATE: 3/1612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 129.28 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE SOAAD OF ACCOUNTS
GENFAAL FOAM 110. 101 11496)
MILEAGE I:LA�IM
(GOVERNMENTAL UNIT} COUNT O
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, D r"T14ENT OR 1NSrnVIION)
SPt;EpOMETER
FROM TO TO tU1 E E
E DATE I READING
�a NATURE OF BUSINESS LES g c
POINT POINT START FINISH FA�U
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AUTO LICENSE NO. TOTALS L L D 3
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits
and tNpl rt 1 the same has been paid.
Date
MAR 03 2011
BY:
PRESCRIBED BY STATE BOARD OF ACCOUN[s GENERAL FORM 110. 101 (14RS)
MILEAGE CLAIM C
(GOVERNNENIAL MY)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTI3NF Oft INSrIMION)
SPEEDOMETER
DATE FROM TO READING AUTO �E
POINT POINT START FINISH NATURE OF BUSINESS TpN E S C
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AUTO LICENSE NO, TOTALS Ie�m
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 aliowing all just credits r
end thNO of the same has been paid.
Date it C,
ti MAR 0 3 2011
BY.
PRCScR18E0 BY STATE BOARD OF ACCOUNTS GENERAL FORM IIO. IN (1486}
MILEAGE CLAIM
To
(GOVERNMENTAL DNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTIONT OR INST=108)
SPEEOOMETFA LLgg
PROD TO I READING A t.4I.ES Q r AfE
2o POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS u
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 n I park of m
the sae has been paid.
II 1
Date
ERR Q 3 2011
BY:
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
311111 Reimb Mileage 113 3/1/11 129.28
Total 129.28
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of$
129.28
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 129.28 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 -Mar 2011
Signature
129.28 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund