HomeMy WebLinkAbout161787 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 360282 Page 1 of 1
ONE CIVIC SQUARE ALICIA DECKARD
0 CHECK AMOUNT: $242.90
CARMEL, INDIANA 46032 e147 w ioso s
FORTVILLE IN 46040 CHECK NUMBER: 161787
CHECK DATE: 7/23/2008
DEPARTME ACCOUNT PO NUMBER INVOICE NUMBER AMO UNT DE
=1046 4343000 242.90 TRAVEL FEES EXPENSE
I
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM i
v
(GOVERNMENTAL uxrr) ON ACCOUNT OF APPROPRIATION NO. FOR J
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM SPEEDOMETER
AUTO MIL GE
DATE TO READING NATURE OF BUSINESS MILES 0
POINT POINT START FINISH TRAVELED
PER MILE
a i r
Y) 1 IUD (o
7 13 7 c
3 M L EJA rr
3 i -,k
011 r i 13 V1 t
a
7
3; io T i q7� a n g l
r� �r do v ql i q ti
3 r
rn NU
D
1-121) 7 13 T L
r 0 1 tR
1 3 7 U I /-t q
3a In nn v 7 e 77
i M MZ4 10719 7q36'
T M -n en i3 0 c -7
1 D 1
r 3 c,
1383q 3
r T P T fta 3 ci_ rn�m 7- yzkA G��
P C 6n 71 7 l� 7 7 to .-f is
AUTO, LICENSE NO. TOTALS I l (0 J c—'
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 du ,after allowing all just credits
znd that no part of the same has been paid.
Date
vv
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR I JUL o 8 2 o
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE
NATURE OF BUSINESS MILES
U— POINT POINT START FINISH TRAVELED
PER MILE
P T r
7
`f r 7
1;?4 P11 on cn 7
r I1] 135 k eil2 'i �z-C �ux� k I
o Oc' 7
t 7 lc
lbU r i�
i M tn' l ilf O7 io5
tit
p t T r t 7V "v. to W [e i
i 8
ra
l
Pr
2 PT" PT D l a b
7 r r 4.2 i l J V
PRE 8� l vc� J
aZq d 30
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 legally du fter allowing all just dits
.end that no part of the same has been paid.
Date
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
M
fD M 0
G]
0
Allowed 19_ 0
.04 rr
a
�,o�'
in the sum of m
w
CD As
m 0
W
I W 0
5' a 0
0
(Board or Commission) 0 rt
CD
0 a
CD
FILED
p
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(Official Title) o
A.E. BOYCE CO., INC. MUNCIE, IN 01136 n
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.
Deckard, Alicia Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/27/08 reimb. Mileage 2/26/08 4/16/08 116.65
6/27/08 reimb. Mileage 4/17/08 5/30/08 126.25
Total 242.90
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.
Deckard, Alicia Allowed 20
In Sum of
242.90
ON ACCOUNT OF APPROPRIATION FOR
104 Program
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 116.65 1 hereby certify that the attached invoice(s), or
1046 reimb. 4343000 126.25 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
242.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund