HomeMy WebLinkAbout201195 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 363065 Page 1 of 1
s �i 0 ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $422.95
a CARMEL, INDIANA 46032 C/O PARKS ESE
CHECK NUMBER: 201195
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 422.95 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM IIG. 101 (1986)
1 MILEAGE CLAIM M(
1
c� t La Por1Ss TO �1
(OOV ENIAL UNln
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFi)CE, BOARD, DEPARTMENT OR INSTMJTION)
FROM TO SPEEDOMETER AU GE 3
DATE READING f
2a NATURE OF BUSINESS MILr
POINT POINT START FINISH TRAV
124 MC r- LA
3 ff ic)
C-
ly
ly L.., C-
MCC l,J CL 19
Lf r
t W
M C. L--) �t 1 o
c M r�
4 i tM C c +o c-
ool d`n C LJ Q, t
1 r
'q 26 M
M +0 c 4 to
Li (Y"'% C c. C-
r- +0 ew `d .a y-�
AUTO LICENSE NO_ TOTALS� 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 legally du after alio g all just cr 'tS
and that no part of the same has been paid.
Date a)
'5 y
PRESCRIBED BY STATE BOARD OF ACCOUNTS GERFRAL FORM 11G. 101 II906)
MILEAGE CLAIM aM C
ccCly) Cl �A G.-ICI-46 ro
C IOOVERNMEf AL UNlTI
ON ACCOUNT OF APPROPRIATION NO. FOR
ETEEDOMETER
�OFTCE, 8011 RD, DFlARTI@fi OR IM52IM10N)
FROM TO I READING O 1/ILEAC
DATE NATURE OF BUSINESS �_t�
Z --I--L POINT POINT START FINISH TRAVELED PER WLE
4(
10
10
G Ct 10
c (i i O
I CLIP 41 00
M -t-o C 1...7
a C w 1 0
t r y 1 a
C tb C X, w
lM
I
1 1 Q
b
10
11 W t
3 1. T a MG t I y
t �l 1 c7
3 1 M r G +g' C 10
3 IS Vy"%CL to W cl t J
3 C LA J Y o
a�
AUTO LICENSE NO. TOTALS D- 9 1 I
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 13,
Pursuant to the provisions and penalties of Chapter 155, Acts 1993, I hereby certify that the foregoing account is just and correct, that the amount claimed egal due, after a ing all jus credits
end that no part of the same has been paid.
Date
�q
o�� 1
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NC. 101 (19867
MILEAGE CLAIM
TO rn e O
MENTAL UNI'n
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DUARTMENT OR 1NSrMFYI0N)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO I READING
�d 1— POINT POINT START FINISH NATURE OF BUSINESS
TRAVELED
PER MILE
L1`—
b A-
I I I
w �.s
ate__
s
l to McC.�.
I p-r nn I 777 ti
t t p tyl C I I
1 19 P
a
I e�
r� .15
ah r C- 1
fi s
M 1
117
—;L
P
PQ' T I I O
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 l ally due after a o g all redits
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.
363065 Dowell, James Terms
14328 Banister Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/5/11 Reimb. Mileage 1/1/11 4/29/11 169.07
9/5/11 Reimb. Mileage 1/1/11 4/29/11 116.08
9/5/11 Reimb. Mileage 1/1/11 4/29111 137.80
Total 422.95
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.
363065 Dowell, James Allowed 20
14328 Banister Dr
Noblesville, IN 46060
In Sum of
422.95
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1081 Reimb. 4343000 169.07 1 hereby certify that the attached invoice(s), or
1081 -3 Reimb. 4343000 116.08 bill(s) is (are) true and correct and that the
1081 -3 Reimb. 4343000 137.80 materials or services itemized thereon for
which charge is made were ordered and
received except
8 -Sep 2011
�lX
Signature
422.95 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
,n�a �s e.