HomeMy WebLinkAbout201288 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 364694 Page 1 of 1
ONE CIVIC SQUARE JOSHUA JONES
s i CHECK AMOUNT: $20.20
CARMEL, INDIANA 46032 3624 QUINCY DR
ANDERSON IN 46011 CHECK NUMBER: 201288
CHECK DATE: 9/1312011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 20.20 TRAVEL FEES EXPENSE
PRFSCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM o
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF. BOARD, DEPARTLLFNT OR INST rLrrION)
SPEEDOMETER
D1}7E FROM TO READING AUTO MILEAGE C
2� POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
1
Jf en P W0A
m r P
a
c
AUTO LICENSE NO. TOTALS 3 (o) y
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 aliowing all just credits
and that o part of the '1 same has been paid.
Date a
HN 1
I� 06 w�
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.
364694 Jones, Joshua Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/31 /11 Reimb Mileage 7/26 813/11 20.20
m Total 20.20
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
e
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
364694 Jones, Joshua Allowed 20
In Sum of
20.20
ON ACCOUNT OF APPROPRIATION FOR
908 ESE
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1082 -1 Reimb 4343000 20.20 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
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Signature
20.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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