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HomeMy WebLinkAbout198734 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 364943 Page 1 of 1 ONE CIVIC SQUARE VICKI RUBIO CARMEL, INDIANA 46032 CHECK AMOUNT: $39.27 CHECK NUMBER: 198734 o, CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 39.27 TRAVEL FEES EXPENSE i I i PRLSCRI BED BY STATE BOARD OF ACCOUNTS GrN FJ1ALiORl111 101 tF9B6) MILEAGE CLAIM C To lC t L IGOVERNMENTAL VN11T ON ACCOUNT OF APPROPRIATION NO. FOR tOFI E, BOARD, DEPARTNtENr OR 1NSrrrArlON) FROM TO SPEEDOMETER AUTO MrLEAGE DATE iE READING 1— POINT POINT START F1N1SH NATURE OF BUSINESS TRAVELED PER MILE t C C d"l .C. YL s L CC- AUTO LICENSE NO. TOTALS f 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 due, after aliowinq all just credits and that no part of the same has been paid. Date dt /01 t fi MAY 20.1011 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, 364943 Rubio, Vicki Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5!17111 Reimb Mileage 512 5117111 39.27 Total 39.27 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. 364943 Rubio, Vicki Allowed 20 In Sum of 39.27 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE N0. ACCT #TrITLE AMOUNT Board Members Dept 1081 -3 Reimb 4343000 39.27 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 ?,1a&&J'Y-) Signature 39.27 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund