HomeMy WebLinkAbout164282 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
ONE CIVIC SQUARE CHARLES A IMAN
CARMEL, INDIANA 46032 12525 OLD MERIDIAN ST APT 317 CHECK AMOUNT: $88.92
CARMEL IN 46032 CHECK NUMBER: 164282
CHECK DATE: 9130/2008
DEPARTMENT A CCOUN T PO NUMBE IN NU MBER AMOUNT DESCRIPTION
1046 4343000 88.92 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM No. 101 (1986)
MILEAGE CLAIM
TO
Gir12015;Z- G�14 Y l��r�.�s T G
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
FROM
DATE TO READING AUTO MILEAGE
NATURE OF BUSINESS MILES x
I9 POINT POINT START FINISH TRAVELED
PER MILE
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AUTO LICENSE NO. TOTALS �j 2 Z
SPEEDOMETER READING columns are to be used only when distance between points.cannot be determined by fixed mileage or official highway map. C
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, of e ruing all just credits,
.and that no part of the same has been paid.
Date
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.
361054 Iman, Charles Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/2/08 Reimb. Mileage 8/5/08 8/29/08 88.92
Total 88.92
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Iman, Charles Allowed 20
361054
In Sum of
i
88.92
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 88.92 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
15 -Sep 2008
Signature
88.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund