HomeMy WebLinkAbout166604 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
t, ONE CIVIC SQUARE CYNTHIA CANADA
CHECK AMOUNT: $85.82
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
NOBLESVILLE IN 46060 CHECK NUMBER: 166604
CHECK. DATE: 12110/2008
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 85.82 TRAVEL FEES EXPENSE
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PRPSCRIBED BY STATE SCARE) OF ACCOUNTS GY)IFRAL FORM NO. 30l (1 NM
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
[OHICE, HOARD, D£PARTWEN'T OR INSnTU110N)
FROM SPEEDOMETER AUTO MILEAGE
DATE READING
POINT POTNT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
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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. 1
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Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after a rowing a 1 just cre its
end that no part of the same has been paid.
Date
DEC 0 1 2008
PMSCRUED BY STATE BOARD OF ACCOUNTS GENERAL FOMM NG. IN (J"F)
MILEAGE CLAIM C j n t r
(pOWFRNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION Np- FOR
(OFFICE. HOARD, DFYARTIDM OR INSPRIEIION)
FROM TO SPF�60METEA AUTO MIL
DATE I I READING t
2 POINT POINT START FINiSI{ NATURE OF BUSINE56 TAAVIEtiED Cd
PER MILE
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AUTO LICENSE NO. TOTALS
a
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 5 a
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 he s e has been paid.
Date l I
e�
DEC 0 1 2008
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.
360144 Canada, Cyndi Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/18/08 Reimb. Mileage 10/13/08 11/18/08 85.82
Total 85.82
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.
360144 Canada, Cyndi Allowed 20
In Sum of
85.82
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 85.82 1 hereby certify that the attached invoice(s), or
blll(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
Signature
85.82 Accounts Payable Coordinator
ost dis trik.tion ledger classification if Title
c1 im paid motor vehicle highway fund