HomeMy WebLinkAbout200086 08/03/2011 CITY OF CARMEL, INDIANA VENDOR: 364657 Page 1 of 1
ONE CIVIC SQUARE JESSICA RICHARDS
CHECK AMOUNT: $57.98
CARMEL, INDIANA 46032 1832 N GLENDORA DR
INDPLS IN 46214 CHECK NUMBER: 200086
CHECK DATE: 8/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 57.98 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. IN (1986)
MILEAGE CLAI qi tC h Q C
TO
(aOVERN)dENrAL i1NiT1
ON ACCO T OF APPROPRIATION NO. FOR
(OF.ICE, BOARD, DEPARTMENT OR INS7mnioN)
SP
DATE FROM TO READING TFR AUTO MILEAGE
READING NATURE OF HVSINE56 MISS
TRAVELED
POINT START FINISH
PER MILE
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AUTO LICENSE NO- TOTALS I 2 SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. J
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the loregoing account is lust and correct, that the amount claim is legally due, afte gall just credits
and that no part of the same has been paid. w
Date
Z 4 10 i
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.
364657 Richards, Jessica Terms
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) PO
57.98
6123/11 Reimb Mileage 616 6/23/11
Total 57.98
I 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.
364657 Richards, Jessica Allowed 20
In Sum of
I
57.98
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -6 Reimb 4343000 57.98 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
26-Jul 2011
Signature
57.98 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund