HomeMy WebLinkAbout163247 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
ONE CIVIC SQUARE CHARLES A IMAN
CHECK AMOUNT: $151.16
CARMEL, INDIANA 46032 12525 OLD MERIDIAN ST APT 317
CARMEL IN 46032 CHECK NUMBER: 163247
CHECK DATE: 9/3/2008
DEPARTME ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 151.16 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
R CEJ MILEAGE CLAIM /7
TO
AUG 1 1 2008
,(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM To READING MILS MIL x EAGE
18 NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED PER MILE
�t' 94 Q AJi
7 32 D
o 1,�� rrVr ovo SGT' �.r2 SS ioa/
ea Gc.ct� o i oat�ry 2vt c�7
�LGb6E moe'yovy
JA c'rr V MPi9 L- ?VIC
G k/0e
Coo Az>an Orr., r
AUTO, LICENSE NO.
TOTALS S
`d 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 isdegall e, after allowing' all just credits
.and that no part of the sanle has been paid.
Date
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
-C ZE IEYVED T
(GOVERNMENTAL UNIT) AUG 1 1 2008
ON ACCOUNT OF APPROPRIATION NO, FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO
I READING AUTO MILEAGE
NATURE OF BUSINESS MILES c
19 POINT POINT START FINISH TRAVELED
PER MILE
�c 2 R
0
o�
v S
GReAr T ml F/ezb rah 661( Ve 5 ca5mul
D �S a, 6 k o .I/ G�
two f✓ l Uc 'jr)/Z Z a cS '3/04J 9,,V-r,9 r f
li-bo7 Mdiuo T2 ivc
A
o4s u oo D 1 2 o
3 1 Uta.��� G(i�U N1 Cl VL c.�
ND -72Q
AUTO LICENSE NO. //V.� /ANfb 9 5� li TOTALS 1 6
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, a 1 wing all just credits
..-nd that no part of th same has been paid.
Date n
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
8/11/08 Reimb. Mileage 5/19/08 8/4/08 151.16
Total 151.16
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
II
Voucher No. Warrant No.
hPan, Charles Allowed 20
361054
In Sum of
151.16
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 151.16 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
18 -Aug 2008
Signature
151.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund