HomeMy WebLinkAbout155960 01/23/2008 CITY OF CARMEL, INDIANA VENDOR.' 360770 Page 1 of 1
ONE CIVIC SQUARE ADAM WOOD
CARMEL, INDIANA 46032 1235 N DELAWARE CHECK AMOUNT: $42.87
INDIANAPOLIS IN 46202 CHECK NUMBER: 155960
CHECK DATE: 1/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1 4343000 42.87 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS R F
y t� 4 T I GENERAL FORM NO. 101 (1986)
FUND MILEAGE CLAIM
PT I TO JAN o S zoos
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO S..- FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER MI EA
DATE FROM TO READING AUTO NATURE OF BUSINESS MILES d
19 POINT POINT START FINISH TRAVELED PER MILE
fir" v,4
l 11
'6 r 71
C A
11 j
Ll
a 77
a 03 it 1
T
1 3.
I d
d 1$
i 3 L/
1 1 1 5 Q
AUTO LICENSE NO. TOTALS l
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,
end that no part of the same has been paid.
Date
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i 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.
i
Payee
1 Purchase Order No.
Adam Wood Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/8108 reimb. 2007 Mileage reimb 42.87
Total 42.87
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
i
Voucher No. Warrant No.
Adam Wood Allowed 20
In Sum of
42.87
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 42.87 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
17 -Jan 2008
Signature
42.87 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund