HomeMy WebLinkAbout159047 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 360204 Page 1 of 1
ONE CIVIC SQUARE SAMUEL RICHARDSON
CARMEL, INDIANA 46032 11109 ECHO CREST EAST DRIVE CHECK AMOUNT: $26.26
INDIANAPOLIS IN 46280 CHECK NUMBER: 159047
CHECK DATE: 4130/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 26.26 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
RECEIVED MILEAGE CLAIM
T O s5CZ w- 1 �U d
(GOVERNMENTAL UNIT) APR 1 6 2008
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) Y.
DATE FROM TO SPEEDOMETER AUTO MILEAGE
READING NATURE OF BUSINESS MILES S
POINT POINT START FINISH TRAVELED PER MILE
2 1 C Y 19 1. /ki n G6 vd C 2
5
o f
r- -o
f
i 1 2
20
AUTO LICENSE NO. TOTALS Z Z
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
2
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
znd that no part of the same has been paid. 16
Date
y.3 y3 6 00
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.
Sam Richardson
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
16-Apr-08 Reimb Mileage Reimbursement 26.26
Total 26.26
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.
Allowed 20
Sam Richardson
0
0 In Sum of
26.26
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb 4343000 26.26 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
22 -Apr 2008
4
S4
26.26 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund