HomeMy WebLinkAbout166180 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
0 ONE CIVIC SQUARE TIFFANY BUCKINGHAM
CARMEL, INDIANA 46032 5130 PRIMROSE AVE CHECK AMOUNT: $165.85
INDIANAPOLIS IN 46205
CHECK NUMBER: 166180
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 165.85 TRAVEL FEES EXPENSE
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t
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM No. 101 (1986)
MILEAGE CLAIM
TO i.1 Gl V1 �I i�'�.� S
1Qe4 e" av
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) 7 00+
SPEEDOMETER 7 -00+ AUTO MIL
D$TE FROM To READING MILES
!1� POINT POINT START FINISH 1 4-00+ SINESS TRAVELED
1 4- 00+ PER MILE
q c tee o
a 14 00+ T.
9 I 14.00+ 1
C 10.00+ I O
CT 20-00+
o y
c-1 7 oo+
(6 c y C, 7-00+ aG
11.00+
q 2 oV�o +0 O
9 ono �r i 21.00+
o -7 a� i--�Ct
C 5 50+ 12 0
U r,A0 1 7.00+ 5 .5
O ptirlp CT r'o 6k W a 1 G 1 7. 0 0+ 0
10 C 1 2 50+
o. 2•�
c o wL 2.50+
t Z.
Ib ZL V1G� cbo\ 5 °00+
o 7 °00 .d
o; j- 10-00+ 0
(I
1► G 2. E D �C I 14-00+
I
it G: 20-00+
C 1 4.00+ O 1(05 (J'
AUTO LICENSE NO. 14-00+ S 2'9
283.50*
SPEEDOMETER READING columns are to be used only when distance between points be determined by fi; p.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953.,_ hereby_certify,_that the foregoing account is j ned is lega e, after allowing' all just credits
land that no part of the same has been paid.'
Da NOV 1 7 2W8
BY:
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.
358108 Deters, Tiffany Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/08 Reimb. Mileage 918108 11/10/08 165.85
Total 165.85
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.
358408 er Tiffany Allowed 20
In Sum of
165.85
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 165.85 I 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
17 -Nov 2008
Signature
165.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund