HomeMy WebLinkAbout166245 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 360926 Page 1 of 1
ONE CIVIC SQUARE SHAVONNE HOLTON CHECK AMOUNT: $27.50
CARMEL, INDIANA 46032 8001 CANARY LANE, APT
INDIANAPOLIS IN 46260 CHECK NUMBER: 166245
CHECK DATE: 11/2412008
DEPARTMENT ACCOUNT PO NUMBER.. INVOICE NUMBER AMOUNT DESCRIPTION
'1 4343000 27.50 TRAVEL FEES EXPENSE
N
PRFSCRIBrP By STATE. BOARD OF ACCOUNTS GrNF.RAL FORW 11G. 101 04867
MILEAGECL oi
(GOVERNMENTAL UNIT} ON ACCOUNT OF APPROPRIATION NO_ FOR
(OFZCE., BOARD, DE ARTMZNT OR INST=IDN)
JyE� FROM TO SPEEDOMETER AUTO
zdD MILE E
POINT POINT STQRT� FINISH NATURE OF Bt7S1NESS MILES TRAVELED PER MILE C
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AUTO LICENSE NO. TOTALS"]
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map. l
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just aDd correct, that the amount claime a ly ue, of ared its
end that no art of the sa has been paid.
Date
7B Y
r
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.
360926 Holton, Shavonne Terms
8001 Canary Ln Apt A Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/08 Reimb. Mileage 9129108 10/31/08 27.50
Total 27.50
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.
360926 Holton, Shavonne Allowed 20
8001 Canary Ln Apt A
Indianapolis, IN 46260
In Sum of
27.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 27.50 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 -Nov 2008
Signature
27.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund