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HomeMy WebLinkAbout201307 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 364002 Page 1 of 1
ONE CIVIC SQUARE ASHLEY LIVINGSTON
CARMEL, INDIANA 46032 CHECK AMOUNT: $79.92
3404 WOODFRONT PLACE
INDIANAPOLIS IN 46222 CHECK NUMBER: 201307
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 79.92 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAL 110. 101 (1986)
MILEAGE CLAIM
ro (GOVERNMENTAL UNIT)
ON ACCOUNT OF APPRNPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMEWT OR INST=108)
SPEEDOMETER AUTO MMEAGE
DATE FROM To I READING NATURE OF BUSINESS MILES a
2 POINT POINT START FINISH TRAVELED PER MAC
2, mlffrYorN
AU4 -4
C51� Z h
CT
l
i
I
AUTO LICENSE NO. TOTALS Q q2
TOTALS '"i I
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. i
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
and that no part of the same has been paid.
Date
AUG 1 1U11
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.
364002 Livingston, Ashley Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/12/11 Reimb Mileage 8/1 8/12/11 79.92
Total 79.92
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.
364002 Livingston, Ashley Allowed 20
In Sum of
79.92
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 79.92 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
79.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund