HomeMy WebLinkAbout164591 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BA RLLINGER CHECK AMOUNT: $35.04
CARMEL, INDIANA 46032
CARMEL IN 46032 CHECK NUMBER: 164591
CHECK DATE: 10116/2008
D ACCOUNT PO NUM INVOI NUMBER T AMOUNT DESCRIPT
1125 4343000 35.04 TRAVEL FEES EXPENSE
t
i
I
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
VERNME TAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOA D, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM To READING NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED PER MILE
/UOK& CT 4 &A t l W -w4 tp o,5 r
11 Ah.K 4 CITY NAL.L- f h d
it 64 rd'
1 I
q lid 96 05't 40 `l
tt e�
q 9( n it
f l q dJl e V" L.. I.
XD L
I Z JI L'L uit'LC... 'A oG e-I
a s 01
If
ate} i� 1111 �L{AI. I S Cie
ll
t 1J B �I
r
r it
C �-t N 11�?L Gf
i 1
AUTO LICENSE NO. TOTALS fj��/ 1 D.q
JJ i
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 Towing all just credits
and that no part of the same has been paid.
Date
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 Appiopriation No. for
W 0)
n rA m
m
j Allowed 19 M 0 o
n a a rr�
in the sum of Q
a
m
ro m
m' Ia a
m
I
s Q tr 0
Q `t m
(Board or Commission)
C �L I rt
w
FILED
CD
m w
m a
(Official Title) o o
r.
o_
m
A.E. BOYCE CO., INC. MUNCIE, IN 01136 n
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.
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, IN 46032
Invoi4;; oice Description
Datmber (or note attached invoices) or bill(s)) Amount
9/25 imb Mileage 7/7/08 9/9/08 35.04
J
Total 35.04
I 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.
359600 Ballinger, Helen Allowed 20
12913 Currier Street
Carmel, IN 46032
In Sum of
i 35.04
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4343000 35.04 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
1 -Oct 2008
Signature
35.04 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund