HomeMy WebLinkAbout197111 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
e ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: $90.10
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
NOBLESVILLEIN 45000 CHECK NUMBER: 197111
CHECK DATE: 5111/2011
DEPA ACCO PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTI
1081 4343000 90.10 TRAVEL FEES EXPENSE
PRESCRIBCO BY SrATt BOARD OF ACCOUNTS GENERAL FORW NG- 101 11986)
MILEAGE CLAIM
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(GOVERNMENTAL UNITi ON ACCOUNT OF APPROPRIATION NO.' FOR
tOF�10E, HOAAn. DEFAAT3NT OR imsm-UnON1
SPEEDOMETER AUTO WEX AG E
DATE FROM TO READING NATURE OF RUSINESS MILES
2a 'OrNT POINT START FINISH TRAVELED PER MILE
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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, 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 part of t e same has been paid.
Date
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APR
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BY.
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 11988)
MILEAGE CLAIM
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ON ACCOUNT OF APPROPRIATION NO. FOR
(OFi7cE BOARD. DEPARTMENT OR IN"TRUrION)
SPEEDOMETER
DATE FROM TO READING AUTO E
NATURE OF BUSINESS MILES a
PO
POINT POINT START FINISH TRAVELED PER MILE
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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_ Illccc!!! 1
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
and Date that 1" no of e samg has been paid.
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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
4125111 Reimb Mileage 313 4125111 90.10
Total 90.10
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of
90.10
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 90.10 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
4 -May 2011
Signature
90.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund