HomeMy WebLinkAbout163701 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 360282 Page 1 of 1
s.� ONE CIVIC SQUARE ALICIA DECKARD
CARMEL, INDIANA 46032 8147 w 1050 s CHECK AMOUNT: $117.37
FORTVILLE IN 46040 CHECK NUMBER: 163701
CHECK DATE: 9/17/2008
DEPAR ACCOU PO NUM BER INVOI NUMBER AM OUNT DES
1046 4343000 117.37 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110. 101 (1486)
MILEAGE CLAIM
TO
(GOVERNMENTAL UN1T1
ON ACCOUNT OF APPROPRIATION NO. FOR
(OrnCE, BOARD, DEPARTMENT OR INSTITUTION)
DAT FROM TO I T READING AUTO 1 )AIL
MILES V oly PONT PONT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
r 4 of e d U
4 L a L
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LI c• t
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`s t 52 t t c r
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AUTO LICENSE NO. TOTALS O
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 e, alter allowing all just c di
and that no part of the same has been paid.
Date
I
c va.
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.
z 360282 Deckard, Alicia Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/29/08 Reimb. Mileage 6/24/08 8/27/08 117.37
Total 117.37
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.
360282 Deckard, Alicia Allowed 20
In Sum of
117.37
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 117.37 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
2 -Sep 2008
Signature
117.37 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund