HomeMy WebLinkAbout197741 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 361086 Page 1 of 1
k+ ONE CIVIC SQUARE JACOB C MOORE
CHECK AMOUNT: $40.60
CARMEL, INDIANA 46032 348 ATHERTON DR
CARMEL IN 46032 CHECK NUMBER: 197741
CHECK DATE: 5/26/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 40.60 TRAVEL FEES EXPENSE
r J l./ �y� r q
PRESCRIBED BY STATE BOARD OF A ft CCOUNTS t I./--LF (D M P- GEXFAAL FOAM No, IN €19063
MILEAGE CLAIM 7MAd L BEM
(GOVERNMENTAL WI'n
ON ACCOUNT OF APPROPRIATION NO. FOR
tOF710E BOARD. DFPARTICWT OR INSr=108)
T SPEEDOMETER DATE FROM TO �E I HEADING NATURE OF BUSINESS MILES 0 c
POINT POINT START FINISH TRAVELED Pfd
2,
1
f
C AZ7,Ai
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1
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING colwnns are to be used only when distance between points cannot be determined by fixed mileage or official highway map
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
and that no part of J the same has been paid,
Dale
I F F
M Y 1 2011 b
BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMCL
An invoice of bill to be properly itemized must show; kind of service, where
whom, rates per day, number of hours, rate per hour, number of units, price Per performed, dates service rendered, by
Payee
p unit, etc.
361086 Moore, Jacob Purchase Order No.
Terms
Invoice Invoice
Date Number Description
5/5/11 (or note attached invoice(s) or bill(s))
Reimb. Mileage 3/21 5/5/11 PO
Amount
40.60
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited with IC 5- 1 1- 10 -1.6 Total
+ted same in accordance 40.60
20
Clerk Treasurer
Voucher No. Warrant No.
361086 Moore, Jacob Allowed 20
In Sum of
40.60
ON ACCOUNT 0.- APPROPRIATION FOR
'!f$ ESE
PO# or INVOICE N0. ACCT #MTLE AMOUNT Board Members
Dept
1081 -1 Reimb. 4343000 40.60 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
19 -May 2011
Signature
40.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund