HomeMy WebLinkAbout165867 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 00353070 Page 1 of 1
ONE CIVIC SQUARE DAVID MCCOY CHECK AMOUNT: $56.16
CARMEL, INDIANA 46032 C/o
C/o is CHECK NUMBER: 165867
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBE I NVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 .56.16 EXTERNAL TRAINING TRA
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM I .�Ll
L EI O F C AR M TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READING T +R OS MI AGE
NATURE OF BUSINESS Q
MILE
44 0`2 POINT POINT START FINISH TRAVELED PER MILE
Ju�
'2-0 0 1 P oo C' s7pr AJ0T3CBVJLLr_ cVT_ Pie/09b L
Ir Ntli3t- FSU(1_L(' rov�'� CT—f? OL- STA
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6C__ 15 20 Fc"Ljdi�- S vuc S /?AIL P-t5L C c ECK
GCT -2 y 2 DG1 (I s ,R MA 1 STREET PA1 AJ
2R 1 W E FL W dRK) I S M N6
CT Po V.
AUTO LICENSE NO. TOTALS
.SPEEDOMETER READING columns are to be used only when distance between points cannot be determined. fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the forcigoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
and that no� part of the same has been paid.
J
Date c 5 r
Claim No Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
o l0 That it is duly authenticated as required
by law
I That it is based upon statutory authority,
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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A.E. BOYCE CO., INC. MUNCIE, RI 01136 'Q 0
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
f ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
David McCoy Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Mileage $56.16
Total
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'NU1 WARRANT NO.
Mccoy ALLOWED 20
IN SUM OF
i
$56.16
ON ACCOffg APP FUND ION FOR
1202 Informatin Systems
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1202 30 -02 $56 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
20
ignat r
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund