HomeMy WebLinkAbout166808 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 359164 Page 1 of 1
ONE CIVIC SQUARE KEN MILLER CHECK AMOUNT: $87.75
CARMEL, INDIANA 46032 766 GRACE COURT
CARMEL IN 46032 CHECK NUMBER: 166808
CHECK DATE: 12/10/2008
0, PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1150 4343004 87.75 TRAVEL PER DIEMS
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t :.o.rcl Form No. 101 uvu
MILEAGE CLAIM
(GOVERNMENTAL UNIT) TO DR.
(OFFICE. BOARD, DEPARTMENT OR INSTITUTION)
ON ACCOUNT OF APPROPRIATION NO. FO
DATE FROM TO I SPEEDOMETER I AUTO MIL E
�'9 _L1S:J READING+ I MILES
POINT POINT START FINISH NATURE OF BUSINESS I TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS 17 75
+SPEEDOMETER READING columns are to be used only when distance between
i; 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 cred
and that no part of the some has been paid.
Date /'a A51X99
Claim No. Warrant No. I have examined Rhe with-in :clnim and. hereby
IN FAVOR OF certify as follows:
That it is in proper form.
'7nat. it is -duly authenticated as required
bylaw.
That it is based upon statutory authority.
That it is apparently i correct
incorrect
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On Account of Appropriation No, for Dis ursing Officer J
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BOYCE CO.. MUNCIE. IND. DYi]l