HomeMy WebLinkAbout201398 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 364943 Page 1 of 1
ONE CIVIC SQUARE VICKI RUBIO
CARMEL, INDIANA 46032 CHECK AMOUNT: $93.66
CHECK NUMBER: 201398
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 93.66 TRAVEL FEES EXPENSE
i
PRESCRIBED BY STATE 90AAD Or AcCOUNTr GFNFJIAL FOR51 NC. 101 (1"5)
MILEAGE CLAIM 1
C C so v �m 6
(GOVERNMENTAL UN1T1 ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE, BOARD, DEPARTWXr OR INSIRUTION)
�ADATE FROM TO I 8PEED0METEA AUTO MIL &AG
N' READING NATURE OP 6USINESS MM 4 ES
POINT POINT START FINISH TRAVELED PER MILS 'S
c_
7 r-
5
1
L 1 i' LJS
7 d C ct'c�ar
Z tao
(i(, c L VL-- L
t C— Uk
V�-t KA
1 1 t7
i
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 paualties 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 no pail of the same has been paid. Ar
Date
r
ZLi
LJ 6R
AUG 2 2 2011
BY.......:...
PRESCRIBED BY SrAIr BOARD OF AGCODRT7s
GENERAL FORM NO. IQI {19867
MILEAGE CLAIM �r�^ C f ��I,
C Ci TO U
IGOVERRYENTAL UNLi7 TT
ON ACCOUNT OF APPROPRIATION ND. FOR
LOHIC£, BOARD, DF2AATMEKT OR INSTMJTIOHl
DA F E
FROM TO SPEEDOMETER AUTO }lILEAGE
I READING WLES 20 POINT POINT START FINISH NATURE OF BUSINESS TRAVELE6 5`7� S r
PER MILE
r 7 1
t
^w
C S
I T
AUTO LICENSE NO_ TOTALS
S6
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 acccunt 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
q 3 q ,-,-ool
SEP
�`L 0
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.
364943 Rubio, Vicki Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8119/11 Reimb Mileage 5/18 8/19/11 62.54
912111 Reimb Mileage 8123 912!11 31.12
Total 93.66
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.
364943 Rubio, Vicki Allowed 20
In Sum of
93.66
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT 4MTLE AMOUNT Board Members
Dept
1081 -3 Reimb 4343000 62.54 1 hereby certify that the attached invoice(s), or
1081 -3 Reimb 4343000 31.12 bill(s) is (are) and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
8 -Sep 2011
Signature
93.66 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund