HomeMy WebLinkAbout199190 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
ONE CIVIC SQUARE DENEYSE SOLAZZO
i CARMEL, INDIANA 46032 14151 PEPIN PLACE CHECK AMOUNT: $156.77
v-
a «aw r CARMEL IN 46032 CHECK NUMBER: 199190
CHECK DATE: 7!6!2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 166.77 TRAVEL FEES EXPENSE
PRLSCRIBED BY STATE BOARD Of ACCOUNTS
GFxF.ARL FORM NG, icl IIBB6I
MILEAGE CLAIM- �`Z
TO ___..VVV000��
[GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTNXXT OR IMMTUTION)
READING DING
FROM TO 3PEDOME AUTO IAILEAGE
i NATURE OF SUSINE56 MILES 0 :51
ZQ 1 f POINT POINT START FINISH TAAVELISD
PER MILE
A41.0
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AUTO LICENSE NO. TOTALS I C,i r'm
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 allowing all just credits
end that no part of the same has been paid.
Date
J UN 2 120
B Y:
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOR], NO. 101 (1Wb)
MILEAGE CLAIM Li 1 l(S LA2
ro C►� t
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION HO- FOR
(OfacE, BOARD, UEPARTWICHT OR 7NSTMJTION)
rt_ SPE M
E�OETFR AUTO MILEAGE
DATE FROM TO READING MILES 6 .51 C
NATURE OF BUSINE56
POINT POINT START F[NISH TRAVELSO PER LE
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AUTO LICENSE NO. TOTALS
h5� .G
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 aliowin all just credits
and that no part of the same has been paid.
Date
IF
0
jUN 2 1 2111
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.
364715 Solazzo, Deneyse Terms
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5126111 Reimb Mileage 3110 5126111 166.77
Total 166.77
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.
364715 Solazzo, Deneyse Allowed 20
14151 Pepin PI
Carmel, IN 46032
In Sum of
166.77
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #f AMOUNT Board Members
Dept
1081-9 Reimb 4343000 166.77 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
28 -Jun 2011
NJUD-ninIA
Signature
166.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund