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HomeMy WebLinkAbout196101 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1 ONE CIVIC SQUARE VALESKA SIMMONDS CARMEL, INDIANA 46032 2703 E LYNN ST CHECK AMOUNT: $133.83 ANDERSON IN 46016 CHECK NUMBER: 196101 CHECK DATE: 3129/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 133.83 TRAVEL FEES EXPENSE PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NC. IQI 11M0 MILEAGE CLAIM 2� P{` n f ro V�, J(� (GOVERNMENTAL UNIT? ON ACCOUNT OF APPROPRIATION NO. FOR (OF710E, BOARD. DEPARTMENT OR INSnrUTION) DA TX FROM TO S READNG AUTO f--LE W OE POINT POINT START FINISH NATURE OF BUSINESS TRA fiD Cdi t r I MCA- 11 2 r Q e. _i6 M �G 1h M f4C L Fog AUTO LICENSE NO- TOTALS SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is le ly a, after aliowing Must credits. and that no r parl of the same has been paid, Date L. 1 7 MAR 2011 BY: PRESCRIR ED BY STATE BOARD OF ACCOUNTS GENEIIAL CORM NG. 101 tm&) MILEAGE CLAIM TO Q les k a m` 'Y� (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTMENT OR INSrMirlog) FROM TO SPEEDOMETER AUTO WUAGE DATE HEADING Z a PORJT POINT START FINISH NATURE OF BUSINESS TRA MILE PER MILE MCC A e _l LL tr1 1 L I A CL AUTO LICENSE NO_ TOTALS SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby cartily that the foregoing account is just and correct, that the amount claimed is legally due, after atiowing all just credits end thaJ�rTi ja�t of the same has been paid. f� Date y ff 1 J O Lj it MAR X02011 BY: PMCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. IPI (1W$) MILEAGE CLAIM e r�� 4 q (GOVERNMENTAL UNI1T l ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD. DLP"TMDR OR INSTMJTION] FROM TO SPEEDOMETER AUTO UrLEAGE DATE READING POINT POINT START FINISH NATURE OF BUSINESS MILES TRAVELED PER WLE M 1 s rn" gr- ti i Pi AUTO LICENSE NO. TOTALS rr I S f SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. I9/ Pursuant to the provisions and penalties of Chapter 155, Acts 1453, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, sr allowing all just credits and that no part of the same has been paid. n Dale Li MAR 1 0 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. 359285 Simmonds, Valeska Terms 2703 E Lynn St Date Due Anderson, IN 46016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 314/11 Reimb Mileage 113 3/4/11 133.83 Total 133.83 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 i Voucher No. Warrant No. 359285 Simmonds, Valeska Allowed 20 2703 E Lynn St Anderson, IN 46016 In Sum of$ 133.83 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members Dept 1081 -4 Reimb 4343000 133.83 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 24 -Mar 2011 Signature 133.83 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund