HomeMy WebLinkAbout197144 05/11/2011 CITY OF CARMEL, INDIANA VENDORi 360417 Page 1 of 1
ONE CIVIC SQUARE JESSICA DAVIS CHECK AMOUNT: $59.67
CARMEL, INDIANA 46032 CHECK NUMBER: 197144
CHECK DATE: 5/1112011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 59.67 TRAVEL FEES EXPENSE
I
cENEAAL FORM 110. 101 OWS)
PRPSCRIAED BY STATE BOARD OF ACCOUNTS MILEAGE CLAIM I
TO—
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OF ICE, BOARD, DE AATIQWT OR INSTITUTION)
1___ SPEEDOMETER AUTO
DATE FROM TO I READING tt Q c 1 NATURE OF SUBINESS TRAVELED
POINT POINT START FINISH PER MILE
1
l
i
AUTO LICENSE NO� TOTALS
1
51d DOMETER 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 i legally due, after allowing all just credits
and that no part of the same has been paid. t
Dale
c 1
()4L Y D (V R
APR
U 0,
PAESCRIBCD BY STATE BOAR Of ACCOUNTS GENERAL FORM TM. 101 tl %67
MILEAGE CLAIM
TO
(GOVUHMENrAL UNIT')
ON .ACCOUNT OF APPROPRIATION NO. FOR
LOTFICE, BOARD, DUART1gI(T OR 1NSTrniTION)
SPEEDOMETER AUTO
DATE FROM TO READING NATURE OF BUSINESS YJLES a
POINT POINT START FINISH TRAVELED PER MILE
Nub
Ai
a
i Z4
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 le ally due, after allowing a t credits
end that no part of the Same has been paid.
Date
4
APR 212011
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.
360417 Davis, Jessica Terms
I
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4112111 Reimb. Mileage 211 3131/1, 59.67
Total 59.67
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.
360417 Davis, Jessica Allowed 20
In Sum of
59.67
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1081 -11 Reimb. 4343000 59.67 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
59.67 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund