HomeMy WebLinkAbout166581 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 361920 Page 1 of 1
ONE CIVIC SQUARE DAVID BITTELMEYER
CHECK AMOUNT: $107.64
CARMEL, INDIANA 46032 8195 WESTFIELD BLVD
INDPLS IN 46240 CHECK NUMBER: 166581
CHECK DATE: 12/1012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NU MBER AMOUNT DESCRIPTION
1046 4343000 107.64 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM �✓l�yF r
a.r h.5 1 pew _J
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF, BOARD. DEPARTWLO(F OB INSTRUTION)
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE
p NATURE OF BUSINESS MILES d SR. 5 c
2 a "Q POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO, TOTALS 0 7 �Gf
/SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by lixed 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 all just credits
and that no part of th same has been paid.
Date 1 I /t t
DEC 0 1 2008
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.
361920 Bittelmeyer, David Terms
Date Due
r
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/26/08 Reimb. Mileage 11/3/08 11/10/08 107.64
Total 107.64
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.
Bittelmeyer, David Allowed 20
361920
In Sum of
107.64
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE N0. ACCT#fTITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 107.64 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 -Dec 2008
VU
Signature
Is 107.64 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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