HomeMy WebLinkAbout197819 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1
ONE CIVIC SQUARE VALESKA SIMMONDS
CARMEL, INDIANA 46032 2703 E LYNN ST CHECK AMOUNT: $95.12
ANDERSON IN 46016 CHECK NUMBER: 197819
CHECK DATE: 5/26/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 95.12 TRAVEL FEES EXPENSE
PRCSCRIBCD BY STATC BOARD OF ACCOUNTS GENF.PAE FOAL[ 710_ wt Ll"5)
MILEAGE CLAIM
(GOVERN CNIAL VNM l
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF ICE. BOARD. orlAATKEwr OA 1NSnTuTtc) tj
SPEEDOMETER
DATE FROM TO READING AUTO 21iLBAGE
POITIT POINT START FINISH NATURE OF BUSINESS RAVELED
PER MILE
rn LC
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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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
and that n art oijhe same has been paid.
Date
dam'
11 r
RA 0
Y 1011
PRESCRIBED BY STATE BOARD OF ACCOUNTS t GENERAL rollm NC. IM 11"s)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNITE
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE. BOARD. DEPAAT6CENT OR INSrrrrr[ON)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING
ES
Z� POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
-7
4y
F
J
y� Z
y- -T
AUTO LICENSE NQ
48
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 aR just credits
end that no part of the same has been paid.
Date N ny t
NA Y 16 2011
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.
359285 Simmonds, Valeska Terms
2703 E Lynn St Date Due
Anderson, IN 46016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4129111 Reimb Mileage 3114 4127111 95.12
Total 95.12
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
i
Voucher No. Warrant No.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of
95.12
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1081 -4 Reimb 4343000 95.12 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
95.12 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund