HomeMy WebLinkAbout201156 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
I; ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $78.32
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
off INDIANAPOLIS IN 46205 CHECK NUMBER: 201156
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 78.32 TRAVEL FEES EXPENSE
PB! rRIBED HS STATE BOARD Or ACCOUNTS GENERAL FORM 110. 101 (1986)
G( y 4 9- e G MILEAGE CLAIM l l C_ ll CRT V \Cl V1f\
1WVERNMENTAL UNin
S ON ACCOUNT OF APPROPRIATION NO. FOR
COFTICE- SOARU. �UARTUIWT on Msr MiTION)
SPEEDOMETER
DATE FROM TO I READING AUTO
NATURE OF BUSINESS
2 a POINT POINT START FINISH TRAVELED PER MILE
1 Z 2
2 C-T-
o^ lbo k to t'lD
it
G
C
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 lust and correct, that the amount claimed is legally due, after aliowing all just credils
and that no part of the same has been paid,
Date
A, i
414740
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 78.32
Amount
8!16111 Reimb. Mileage 6127 8/5/11
Total 78.32
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.
358408 Buckingham, Tiffany Allowed 20
5130 Primrose Ave
Indianapolis, IN 48205
In Sum of
78.32
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #rrITLE AMOUNT Board Members
Dept
1082 -4 Reimb. 4343000 78.32 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
8 -Sep 2011
Signature
78.32 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund