HomeMy WebLinkAbout156492 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER
CARMEL, INDIANA 46032 12913 CURRIER STREET CHECK AMOUNT: $23.95
CARMEL IN 46032 CHECK NUMBER: 156492
CHECK DATE: 2/21/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
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1125 4343000 23.95 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE' CLAIM
L TO :F.TZT p F
(GOVERNMENTAL UNIT) ,IAN 2 'p 2000
ON ACCOUNT OF A OPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE q FROM TO READING NATURE OF BUSINESS MILES MILEAGE
POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS
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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 foregoingi account is just and correct, that the amount claimed is legally due ft r ing all just credits
and that no part of the same has been paid. I
1
Date i
t xo?4f le)�
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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(Board or Commission) 0 rt
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 1Q A (D
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.
Helen Ballinger Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bi[l(s)) Amount
1128108 reimb. mileage reimbursement 23.95
Total 23.95
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Helen Ballinger Allowed 20
In Sum of$
23.95
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 reimb. 4343000 23.95 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
29 -Jan 2008
's
Sign re
23.95 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund