HomeMy WebLinkAbout199585 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1
ONE CIVIC SQUARE MIKE MCBRIDE
CARMEL, INDIANA 46032 C/0 ENGINEERING CHECK AMOUNT: $92.69
C/0 ENGINEERING CHECK NUMBER: 199585
SON
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 92.69 MILEAGE
MIIL LAUh LLAI
TO DR.
(Governmental Unit)
r cf—f On Account of Appropriation No. for
(Office. Board, DelTartment or Institution
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE
201 Point Point Start Finish TRAVELED PER MILE
V�1
i t C>
r
l FI- 7`7
ras- 1 T
Auto License No. TOTALS
17H A Q� irsi
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, 1 hereby certify that the foregoing 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.
Date V/ 0
Clcum No. Warrant No. I have examined the within clam and
hereby certify as follows:
TN FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
f
That it is apparently correct
l incorrect
On Account of Appropriation No. for
Disbursing Officer
C1
Allowed 20 m r
0
in the sum of 0
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
1 �/1
Payee
I kJ Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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 NO. WARRANT NO.
�p ALLOWED 20
IN SUM OF
U) 1
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
I 2 1
ig tp rE
Mj
Cost distribution ledger classification if
Titl
claim paid motor vehicle highway fund