HomeMy WebLinkAbout155859 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 360181 Page 1 of 1
ONE CIVIC SQUARE KATHERINE PETSO
CARMEL, INDIANA 46032 P 0 aox 921
CHECK AMOUNT: $8.10
CARMEL IN 46082 CHECK NUMBER: 155859
CHECK DATE: 1123/2008
DEI"ARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 8.10 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS t- n I O (t GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
AN 1 4 2008 DEPT' 2 To
ID
(GOVERNMENTAL. UNIT) u L D O
DESC ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) 1 /t 1'
SPEEDOMETER
1 DATE FROM TO READING NATURE OF BUSINESS MALES MIL s
ZOO POINT POINT START FINISH TRAVELED
PER MILE
a
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, a er allowing all just credits
and that no part of the same has been paid.
Date
i
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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A.E. BOYCE CO., INC. MUNCIE, IN 01136
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.
1
Payee
Purchase Order No.
Katherine Petso Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/14/08 reimb. 2007 Mileage reimb. 8.10
Total 8.10
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.
Katherine-Petso Allowed 20
In Sum of
8.10
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 8.10 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
i
which charge is made were ordered and
received except
17 -Jan 2008
Si natur
8.10 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund