HomeMy WebLinkAbout161726 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361046 Page 1 of 1
ONE CIVIC SQUARE LISA BERRY
CARMEL, INDIANA 46032 11142 SHAG BARK TRAIL CHECK AMOUNT: $39.14
s r CARMEL IN 46032
CHECK NUMBER: 161726
CHECK DATE: 7123/2008
NEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE A MOUNT DESCRIPTION
1125 4343000 39.14 TRAVEL FEES EXPENSE
i
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
(GOVERNMENTAL UNIT) J �'f3-� 1 a 2 0 8
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)'
DATE �y FROM TO READING SPEEDOMETER AUTO MILEAG&
a POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER
MILE
0 A mI 'c
e- Cr otio i C V 1°1N S S
3 114 0W W C I oN vN Rck fo mid 0�4c 1 0 3. s
3 L 1 C C.i P 3 S
Gr Gi l 1`c. 3.S
3 o 'C� Zed �,u L v 1� ri c r< <c 'r 3. s
a C-� 4 a.
3 a S C- ba ck,
S
U Cis
iJ D
0 Q�_ _4 t
o d G Z i
0 8 A dfo e. 0
r
l rl 11 Ir r ►c ,r .S
p A rr II rr rr ri rl S
Auk b
r r r r
rr rr /1 r rr r/ 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.
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 legall due, after aliowing all just credits
and that no part of s me has paid. �--A d A A(
1 7 Date I`S U a
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
o tr• a
w m o
m
Allowed 19 a
n a w
in the sum of m
H
1{1 QI tr
fD
E
Q' rt
a
o
0
0 K
e
(Board or Commission) p 2.
w m
A Aj
m a»
FILED
t3
a_ :w
a m
m Er
(Official Title) 0 �o
O M
C
A.E. BOYCE CO., INC. MUNCIE, IN 01136 0.,
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
1 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.
Berry, Lisa Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7115108 reimb. Mileage 3117108 616108 39.14
Total 39.94
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.
Berry, Lisa Allowed 20
In Sum of
39.14
ON ACCOUNT OF APPROPRIATION FOR
101 -General
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 reimb. 4343000 39.14 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
16 -Jul 2008
Signature
39.14 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund