HomeMy WebLinkAbout159713 05/21/2008 CITY OF CARMEL, INDIANA VENDOR: 359164 Page 1 of 1
ONE CIVIC SQUARE KEN MILLER CHECK AMOUNT: $75.75
CARMEL, INDIANA 46032 768 GRACE COURT
CARMEL IN 46032 CHECK NUMBER: 159713
CHECK DATE: 5/21/2008
DEPARTMENT ACCOUNT P N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4343004 75.75 TRAVEL PER DIEMS
I
Tr. ibed by Star- Board o' Acwemti.
^,ea at al Forta No. 101 atu
MILEAGE CLAIM
(GOVE NMENTAL UNIT)
TO DR,
4 ON ACCOUNT OF APPROPRIATION N0. FO
(OFFICE. BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM I SPEEDOMETER
TO READING+ AUTO MILEAGE
I MILES o
POINT POINT START FINISH NATURE OF BUSINESS I TRAVELED PER MILE
e s V 2 SS
S
LZA 21"
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r
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AUTO LICENSE NO. TOTALS
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+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 le ally e, er allowing. all just creel
and that no part of the same has been paid.
Date
Claim No. Warrant No. I have exemined the with n:claim. and .hereby
certify as follows:
IN FAVOR OF
That it is in proper form
That it is -duly authenticated as required
by law.
That it is based upon statutory authority.
That it is apparently correct
incorrect
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