HomeMy WebLinkAbout196104 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
0 ONE CIVIC SQUARE DENEYSE SOLAZZO CHECK AMOUNT: $148.20
CARMEL, INDIANA 46032 14151 PEPIN PLACE
CARMEL IN 46032 CHECK NUMBER: 196104
CHECK DATE: 3/2912011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 148.20 TRAVEL FEES EXPENSE
PRESCRIBED By STATE BOARD OF ACCOUNTS GrNFAAL FORM NO. 101 (19661
MILEAGE CLAIM ��z0
TO So l
IGOVERNMENTAL UNIT{
ON ACCOUNT OF APPROPRIATION NO- FOR
(OFFICE. BOARD, DEPARTNtUn OIL INSUM109)
SPEEDOMETER
FROM TO AUTO MILEAGE
DATE READING
NATURE OF BUSINESS M=S CQ r J l
L POINT POINT START FINISH TRAVELED PER MILE
-rm MCC ty L. 2. Ik
7 T MCC
Z MCC TM ti v Scf.a f
MCC
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2 TtA c c.
se 11 M C TM Hv r, i SC IX D.
z TM
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GC
MCC tz, so-c"
2 MCC
2 7K Me
2
j ML
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1 M t ACL
JCL 7 ee��
AUTO LICENSE NO. TOTALS /Yj,Ip�l11 �r- f
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
end that no part of the same has been paid,
Date
N: MA 0 ZO I I
BY: 1 Pt
PRP3CRIRCP EY STATE BOARD of ACCOUNTS
6F�IEM FORM NO- 101 [lab)
MILEAGE CLAIM
TO Deng- ISIL S 13 1 (^--z J
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION ND. FOR
LOr7iCC, ROARp, OEPARFMd NT OR INsLRUrIoN)
FROM TO �5P D AUTO MILEAGE
DATE READING NG MILES 6 1 c
j POINT POINT START FINISR NATURE OF BUSINESS TRAVELED
PER MILE
l L L r
1 M L L
1
WC I
M i(I
iM C�
"T M t
"LL E
S MLi
CL
MCL
1 I 121
1 N1CC T1"\ r rn kv Cc ao
1 I N C
I
cc
I 7-1 Rt L
Z c. I
i r z
AUTO LICENSE NO, TOTALS T�5 rmi 4 tQ
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 no part of th same has been paid.
Date
f R
1 0 2011
BYr.......................
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
1!31111 Reimb Mileage 113 3/9/11
14$.20
Total 148.20
I hereby certify that the attached invoice(s), or bills) 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
148.20
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#TTITLE AMOUNT Board Members
Dept
1081 -9 Reimb 4343000 148.20 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
148.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund