HomeMy WebLinkAbout164843 10/16/2008 a CITY OF CARMEL, INDIANA VENDOR: 360469 Page 1 of 1
ONE CIVIC SQUARE CONNIE MURPHY CHECK AMOUNT: $150.52
CARMEL, INDIANA 46032 9 HENSEL CT
CARMEL IN 46033
CHECK NUMBER: 164843
CHECK DATE: 10/16/2008
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4343004 150.52 TRAVEL PER DIEMS
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Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
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 i
&VL�
r� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
s Y
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same inc 2� rgance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
h ±An 3 bill(s) is (are) true and correct and that the
OZ materials or services itemized thereon for
which charge is made were ordered and
received except
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
PRESCRIBED BY *ATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1988) y
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOMETER
AUTO MILEAGE
READING
NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED PER MILE
AUTO LICENSE NO. TOTALS O Z
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. w
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 d r 11O g s
and that no part of `thee same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
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
Disbursing Officer
On Account of Appropriation No. for
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