HomeMy WebLinkAbout163372 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA REYNOLDS
CARMEL, INDIANA 46032 11410 BURKWOOD DRIVE CHECK AMOUNT: $82.99
CARMEL IN 46033 CHECK NUMBER: 163372
CHECK DATE: 913/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM DESCRIPTION
`046 r 4343000 82.99 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1886)
l
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR R� 1 1 D d S
(OFFICE, BOARD, DEPARTMENT OR INSTTPUTION)
DATE FROM TO SPEEDOMETER READING AUTO MILEAGE V-
NATURE OF BUSINESS MILES S Q, S Q
AM9 POINT POINT START FINISH TRAVELED PER MILE
3 FD 0 -H m S 3 O
3 MIDYIOVI FC- n o K 3tp
onn soh j
D nOVt s thn in Fiel i
20 D r
Z 'FDE Mon n w 4W 1 3 .0.
to 2 Oh ll F G I 3:' D
X5e +o +T QW P r i -7,0
AUG 2UUd
�i
I
I
AUTO LICENSE NO. TOTALS 2 .O
SPEEDOMETER READING columns are to be used only when distance between- points cannot be determined by fixed mileage hr official highway map. J �t I
Pursuant toahe 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, a er allowing all just credits
end that no part of the same has been paid.
liate
i
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO DD
(GOVERNMENTAL UNIT) sa J P �,/�1 �J C
ON ACCOUNT OF APPROPRIATION NO. FOR
R
l
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
I
SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS A ST O MILEAG
IM POINT POINT START FINISH TRAVELED PER MILE J
'7 F P
2 fb Cove 4S m t
1 VS I IFte p WM )Q. Fi I i 0
7 17 1 A rvv F 1� 1, D
7 i s Da n 9v
7 2I E M n r0 W& B D
t I O DOR FD h r ieo 3", D
2.' FDA t
Z Mop 'in
V5 )1 FD E rh
2 1 3: p
TS I
lub I
1
�I
BY:
I
i
AUTO LICENSE NO. S av
TOTALS
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 er allowing all just credits
end that no part of the same has been paid.
Date
I
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRL47ION NO. FOR
I
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE SPEEDOMETER �y FROM TO READING' AUTO MILEAGE
0 aszkrl POINT POINT START FINISH NATURE OF BUSINESS TRAVELED S O S
PER MILE
5' 2 F D E M 0
3 f D h v1 Pay 3.0
D v►- CQ) rn .n 3,0
j
C1 r
S IV I E 0 h ►nom 3
s 9 FD D r a 3•
20 FM-- vy)G)V► Pq 3 D
20 FD �dY i 4O 5• D
S 20 FDE
Z. I 0
2 MOD010 DK ,0
S 3 FDE D a 3.0
5 23 vnon +o v K 0
5 2' F E oV)cc) Pa
15 vi Fb
6 t p n D Ll D r� '7
S. 30 t6 on DE K. 3
5 F D 1^ I 'MMt f= 3.
DE AUG I -Lmn a
n E. .0
ro Oh Drop OFF 3.0
1 E i 0
I Eb e D D i 3
�5 AUTO LICENSE NO. F TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage 'or official highway map. s� O
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 d er alIowing all just credits,
eud that no part of the same has been paid.
Date
i
1
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.
Reynolds, Alyssa Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/11/08 Reimb. Mileage 5/12/08 7/31/08 82.99
Total 82.99
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.
Reynolds, Alyssa Allowed 20
In Sum of
82.99
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 82.99 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
18 -Aug 2008
Signature
82.99 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund