HomeMy WebLinkAbout199864 08/03/2011 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
11508 LUCKY DAN DRIVE CHECK AMOUNT: $94.29
CARMEL, INDIANA 46032
NOBLESVILLE IN 46060 CHECK NUMBER: 199864
CHECK DATE: 8/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 43.24 TRAVEL FEES EXPENSE
1082 4343000 51.05 TRAVEL FEES EXPENSE
PRLSCR[BED BY STATE BOARD OF A000ONT5 GENFAAL FOR4 11O_ IM EMS)
MILEAGE CL
1 C
ro
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICY, HOARD, DEP"TKWT OR INSMMON)
ETER
FROM TO SPEEDOM AUTO AitLE�GE
DATE R£AD
POINT POINT STAA7 FINISH NATURE OF BUSINESS TRAVELED
POINT ED t
PER MILE
non
AUTO LICENSE NO. TOTALS 9 o
SPEEDOMETER HEADING 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 aliowinq all just credits
and that no part of q th same has been paid.
9
Date i ll lac �c
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e7n
PRY-SCRIBED By STATE HOARD OF ACCOUNTS GENF.RAL FORM 14C. 101 119853
MILEAGE CLAIM
To
4GOVERNf1ENTAL UNn1
ON ACCOUNT OF APPROPRIATION NO. FOR
(OfZCE, HOARD, DEPAATUCWT Oa INSTTr1710H)
FROM TO SPEEDOMETER AUTO E
DATE READING
?d POINT POINT START FINISH NATURE OF BUSINESS TRAVELED f
MI
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AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. LLiJJJ
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
end that no part I the same has been paid.
Date 7
y
6k. JUL 1 4 2011
0
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENCRAL FORM 11O_ lei {]4P6)
MILEAGE CLAIM
1GOVERNMEXTAL UNETi C
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICY, BOARD, DOD FTW fT OR INSTRUIION)
SPEEDOMETER
DATE
FROM TO READING AUTO MILE AGE
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED u 1
i PER MILE
Zile %In i
F3 l
31
a i
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rZ r^
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IA,4 1-SA
t
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Gr S
M i fl c
AUTO LICENSE NO TOTALS y
SPEEDOMETER BEADING 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 fOTegoin9 account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no t part of the same has been paid.
Da to f t 1 1
C _3
'U 1 4 2011
B
Land 4
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7112/11 Reimb Mileage 4/26 6/22/11 43.24
7112111 Reimb Mileage 4126 6/22/11 51.05
Total 94.29
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of
94.29
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 43.2.4 1 hereby certify that the attached invoice(s), or
10$2 -2 Reimb 4343000 51.05 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
26 -Jul 2011
Signature
94.29 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund