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
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CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 39.27 TRAVEL FEES EXPENSE
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PRLSCRI BED BY STATE BOARD OF ACCOUNTS
GrN FJ1ALiORl111 101 tF9B6)
MILEAGE CLAIM
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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
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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