HomeMy WebLinkAbout164338 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 361923 Page 1 of 1
ONE CIVIC SQUARE TIFARAH MCMULLIN
CARMEL, INDIANA 46032 631 HOLIDAY DR CHECK AMOUNT: $26.85
FORrvILLE IN.asoao CHECK NUMBER: 164338
CHECK DATE: 9/30/2008
DEPARTMENT A PO.NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 26.85 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILE.AGE CLAIM I((� J� r t n
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM To READING NATURE OF BUSINESS MILS 0
L POINT POINT START FINISH TRAVELED PER MILE
LIE) r i a
ill I�Q fi T r
1 P T ,P 7 r u' P (dP.d
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AUTO LICENSE NO. TOTALS I
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,
lend that no part of the same has been paid.
Date
ACCOUNTS PAYABLE VOUCHER
Y 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. 19246 F
McMullin Tifarah Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/7/08 Reimb. Mileage 8/5/08 8/07/08 26.85
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Total 26.85
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.
McMullin Tifarah Allowed 20
In Sum of
26.85
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept INVOICE NO. ACCT #/TITLE AMOUNT
1046 Reimb. 4343000 26.85 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
15 -Sep 2008
Signature
26.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund