HomeMy WebLinkAbout198597 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 365423 Page 1 of 1
ONE CIVIC SQUARE JESSICA RICHARDS
CHECK AMOUNT: $74.05
CARMEL, INDIANA 46032 C/0 PARKS
o CHECK NUMBER: 198597
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 74.05 TRAVEL FEES EXPENSE
PMCRISED HY STATE BOARD Or ACCCUMTS t, GENERAL FOR16 NO. "1 119811
i
MILEAGE CLAIM
ro
(GOVEBNXENTAL MITI
ON ACCOUNT O PPROPRIATION NO. FOR
tonicE, BOARD" DEFAATWYHT OR iNSrnintoN)
SPEEDOMETER AUTO �t�II�, AGE
'ADATE FROM TO READING NATURE OF BUSINESS MILES {a
POINT POINT START FINISH TRAVELED
PER MILE
131
F
D A
1 b 3
f
�I�F fYl Yl pYl
S
22
13 F r*.orts�
QA
2�I WF>
30 EDE m
D e MOt�mnn
io, r
p ylp
f
D
AUTO LICENSE NO. TOTALS 1 7, Z 3 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, 1 hereby cerltfy that the foregoing account is just and correct, that the amount: claim legally due, after liow" g jus edits
end that no part of the same has been paid.
Date
�t�"F,,.,
Q OVA Y 2 0 2010
BY:
PRESCHWD BY STATE ROARn OF ACCOUNTS GENERAL FORM NC" Wl tl"53
MILEAGE CLAIM L-
TO
(GOVERNMENTAL UHM ON ACCOUNT APPROPRIATION NO- FOR
(OF17CE, BOARD. DEPART07Ft OR INSC=100)
DATE FROM TO I SREADING� NATURE OF BUSINESS A UTO
MILES (y 51 t
POINT POINT START FINISH TRAVELED
PER MILE
2! n 3
22 D msnum
2(P Ty') -&"h
f" b
�>1
L4 I T5ri Y
X
Fp
S
1
Il
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" t
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 clai ed is egally due, after allowing t credit r
end that no art o s m has been paid,
Date r
TO -ooq 'V!"
MAY 20 2011 t,
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.
364657 Richards, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
74.05
5117111 Reimb Mileage 319 5117/11
Total 74.05
I 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 -1.5
20_
Clerk- Treasurer
Voucher No. Warrant No.
364657 Richards, Jessica Allowed 20
In Sum of
74.05
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081-4 Reimb 4343000 74.05 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
16 -Jun 2011
p
Signature
74.05 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund