HomeMy WebLinkAbout197810 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 364943 Page 1 of 1
ONE CIVIC SQUARE VICKI RUBIO CHECK AMOUNT: $53.55
2 CARMEL, INDIANA 4603
CHECK NUMBER: 197810
CHECK DATE: 5/26/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 53.55 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 119SS
MILEAGE CLA
(GOVERNMENTAL UNI11
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DEPARTMFNT OR INsniUTION)
FROM TO SPEEDOMETER AGE
DATE I READING AUTO
2P 4 POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
EA MILE
t
r 1 d _(L'— 0 J
1 c. c d'
"A Y
7 fto no cv s i
o "V
06 S
AUTO LICENSE NO. i TOTALS Iv�
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- legal�e, of a iowing all just credits
end that no part of the same has been paid.
Date /AI/
rJ ip yy
rl
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.
364943 Rubio, Vicki Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4129111 Reimb Mileage 411 4129111 53.55
Total 53.55
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
Voucher No. Warrant No.
364943 Rubio, Vicki Allowed 20
In Sum of
53.55
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1081 -3 Reimb 4343000 53.55 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
1 1'r-1 �-—'L-21��
Signature
53.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund