HomeMy WebLinkAbout166877 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 362100 Page 1 of 1
0 ONE CIVIC SQUARE PAULA SCHLEMMER
CARMEL, INDIANA 46032 9455 CANOPY LANE
CHECK AMOUNT: $8.78
FISHERS IN 46038 CHECK NUMBER: 166877
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 REIMB 8.78 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
1' R To P'�"
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
F DA_ T FROM Y TO
READING MIE S M Q
POINT POI NT START FINISH NATURE OF BUSINESS L
TRAVELED PER MILE
C Jt C t >i a V G
7 A.n to G j. Vou
dc+ a 7 A.D M IY).C. 1 Yom— 1 1 rl e Ml
O I e -to r e o C T cw r V n 4 fd
NN T
20 A.D. TO M Ctnct r r
2 A.0, b K r f etU�n 2=
I
AUTO LICENSE NO. TOTALS 11r
SIM
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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 legally due, after aliowing all just credits
and that no part of the same has been paid.
f l ;�5 RE C D
Date
DEC 0 1 2008
Bv
NOV 2 5
BY:
ACCOUNTS PAYABLE VOUCHER
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.
362100 Schlemmer, Paula Terms
9455 Canopy Lane
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/25/08 Reimb Mileage 10/16/08 11/25/08 8.78
Total 8.78
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.
362100 Schlemmer, Paula Allowed 20
9455 Canopy Lane
Fishers, IN 46038
In Sum of
8.78
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4343000 8.78 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
1 -Dec 2008
F
Signature
8.78 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund