HomeMy WebLinkAbout200801 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM
CARMEL, INDIANA 46032 5130 PRIMROSE AVE CHECK AMOUNT: $29.58
INDIANAPOLIS IN 46205
CHECK NUMBER: 200801
CHECK DATE: 8/3012011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 29.58 TRAVEL FEES EXPENSE
PRESCA18ED BY STATE; BOARD OF ACCOUNTS GENFAAL FOAM NG. JO) (]We)
MILEAGE CLAIM
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[GOVEAN]d utlm
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF11C£, 8 D, DEPARTXEKT on 1NSTM-tr1oN)
11A AAA t pg SPEEDOMETER
�D FROM TO READING AUTO MILEAGE
NATURE OF BUSINESS -15 J_ C
POINT POINT START FINISH TRAVELED PER MILE
I 7�E
O
l
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.
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 allowing all just credits
end that no part of the same has been paid.
Date
AUG 10 2011
A
PRESCRIBED BY ST BOARD OF ACCOI3NT5 GENFAU FORM NO. 101 tl M)
MILEAGE CLAIM
�e TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPIUATION NO- FOR
tOMCE, BOA RD,'DEFART1EENr OR 1NSTMJT1OM
FROM TO I SPEEDOMETER AUTO HSLEAGE
PATE READING NATURE OF BUSINESS MILES (y t
z POINT POINT START F]NFSH TRAVELED PER WLE
L4 I Vz 1ZL1 I
_1.Q1E? z
2 c
Z MO A 0 La F� D r 1 �-y
o/1U I al
AUTO L3CENSF NO TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. rl l 1/1 1 +x
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 allowing all just credits I
and that no part of the same has been paid.
Date
�u
m ;7
AUG 1 1U
gat
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.
358408 Buckingham, Tiffany Terms
5130 Primrose Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8116/11 Reimb. Mileage 5120 8/5/11 29.58
Total 29.58
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.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 46205
In Sum of$
29.58
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -4 Reimb. 4343000 29.58 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
23 -Aug 2011
Signature
29.58 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund