HomeMy WebLinkAbout163141 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 360484 Page 1 of 1
0 ONE CIVIC SQUARE AMY BALDAUF
CARMEL, INDIANA 46032 9441 BENCHMARK DR APT B CHECK AMOUNT: $279.27
INDIANAPOLIS IN 46240
CHECK NUMBER: 163141
CHECK DATE: 9/312008
DEPA RTMEN T ACCOUNT PO NUMB INVOICE N UMBER AM OUNT D ESCRIPTION
1046 4343000 279.27- TRAVEL FEES EXPENSE
I
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEACE CLAIM
Tp
(GOVERNMENTAL. UNIT) ON ACCOUNT OF APPROPRIATION NO, FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILE GE
DATE READING
:;w zf NATURE OF BUSINESS MILES G�7,�j x
POINT POINT START FINISH TRAVELED
PER MILE
M Q 1vton6
r M0 ow
r m K M onW C en te i ,5
NLa y M 60 0 15
Y f 0
Y I ;mc) Ylv ROW M WO C emf r 5
Y- 27 C enter U 5
Y 0 it 5
Y :28 1 r snMIN Plow
May 31 0 C r .5
ma— "tv d'tiG Ovv
Y' er o 5
Y' Y�6 0 w .5
3 0 5
el/ k 9ONV 6 .15
e 10
er r e o
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r o
Mu1 criolf V YV 2008
I C5 rn QV. o 5
-t rn n 1N Ct LOY 5
AUTO LICENSE NO. TOTALS
SPEIMOMETER 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, T hereby certify that the foregoing account is just and correct, that the amount claimed is legally du after allowing' a s credits;,
,and that no part of the same has been paid.
bate
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM
TO 1!
(GOVERNMENTAL UMT) vlar -nTWT nF A *'R0PRTZ "7, FOR
i
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
5PZ AUTO I E
DATE FROM TO REj 0 3TURE OF BUSINESS MILES
TRAVELED
POINT START
POINT i PER MI
Y1 U w 5-50+
18 S 0 Uh Ce Y 5-5o+
n W 5.50+
Z1
r. 2i a r I 5.50+
2-2 0 n 1 5.50+ -5'
�,Ar. 27 mr"Alt�
5.50+
r. p Adm 4-50+
IV 1-
.212 $71� r 4
0�: p o 5-00+
23 5.50+
1
o d –I 5.50+
n 2 on e r I 5.
2 5 o II 5 °50+
25 Mal o Y Kwv 5.50+
6 VNJ fZ141 I 5.50+ 5.5
r Z°9 4 I 5
5 °50+
Y V1, v DW I 5-50+
r p 5- I s
(FYI t 5-50 AUb I I 2008 5
1 y rno ow. 1 5-50+ I S
1n! I 5-50+
r M I 5.50+
AUTO LICENSE NO. I
5 -50
TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be di -50 ial highway map, I I
•50
Pursuant to the provisions and penalties Of Chapter 155, Acts 1953, I hereby certify that the foreg I 1 3 4 5 0 the amount clammed is legally due, It allowing all credits
snd that no part of the same has been paid.
Date
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
To
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR IITSTITUTION)
FROM TO SPEEDOMETER
DATE READING AUTO MILEAGE/
NATURE OF BUSINESS MILES
POD POINT START FINISH TRAVELED PER MILE
g p OK
2 M ul ch -E e
mck
Ma\j 2 Y1 4
0 0 0 .5
aYt e 0" W-b 15
a
ce
a
,o
o r o
e, 1 ey
e c
e rv�C, o G o
e to Q
e r e� nn
e 0
C OPT 1,
6 c-
10
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points he 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 azld correct, that the amount claimed is legally due, after allowing all is,
znd that no part of the same has been paid.
D ate
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1996]
MILEAGE CLAIM
/b�j v sb� Ida
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, HOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER
DATE AUTO LEAGE
READING
ZC1C
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED 2
PER MILE
p 010
rL 5
omyl 1'
0 p
N,M Al I p D 5
a o
MN 2 Svyio -hw
vv PM()Yl
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20 ovto e S u I tr TrA raer 111
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UN
QV
2 6 Q
2 no 60 r,
G Z2 a o 0 1I I
a 2 t o
Z _g
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. f v U
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, er allowing' all just credits
and that no part of the same has been paid.
Date
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.
Baldauf, Amy Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/11/08 reimb. Mileage 3/24108 6/30/08 279.27
Total 279.27
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.
Baldauf, Amy Allowed 20
In Sum of
279.27
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 279.27 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
25 -Aug 2008
Lh LiiV/ym A h 11
Signature
279.27 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund