HomeMy WebLinkAbout161791 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY DETERS
CHECK AMOUNT: $178.16
CARMEL, INDIANA 46032 6264 N CENTRAL
o� do INDIANAPOLIS IN 46220 CHECK NUMBER: 161791
CHECK DATE: 7/23/2008
DEPARTMENT ACCOUNT PO NUMBE I NVOICE NUMBER A MOUNT DESCRIPTION
1046 4343000 178.16 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS 1 I -GENERAL
oFORM-N i (1986)
MILEAGE CLAIM A II
TO 0. .JUL 0 8 2nng I
POUC
(GOVERNMENTAL UNIT r
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOMETER
READING AUTO MILEAGE
NATURE OF BUSINESS MILES tiQ e c c
POINT POINT START FINISH TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS �q I O 9 5 1
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,
snd that no part of the same has been paid.
Date
PRESCRIBED BY STATE BOARD OF ACCOUNTS =W ray ry y GE RM NO. 101 (1986)
MILEAGE CLAIM
JUL 0 8 2[
(GOVERNMENTAL. UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR IBY:
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
FROM TO AUTO MILEAGE
DATE READING NATURE OF BUSINESS' MILES 4: 5
A) ZO z POD POINT START FINISH TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points 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 due, Iter allowing all just credits
end that no part of the same has been paid.
D a €e
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.
358408 Deters, Tiffany Terms
5130 Primrose Ave Date Due
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/27/08 Reimb. Mileage 4/16/08 5/7/08 90.34
6/27/08 Reimb. Mileage 5/8/08 5/29/08 87.82
Total 178.16
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 Deters, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of
178.16
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#1TlTLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 90.34 1 hereby certify that the attached invoice(s), or
1046 Reimb. 4343000 87.82 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
U" X�
Signature
178.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund