HomeMy WebLinkAbout201413 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1
ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $99.90
CARMEL, INDIANA 46032 2703 E LYNN ST
ANDERSON IN 46016 CHECK NUMBER: 201413
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 99.90 TRAVEL FEES EXPENSE
GENERAL FOAL NO. ICI 09861
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
TO Vy
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
tOF:ICA. BOARD. DE?ARTWEWT OR INSTMVTION)
SPEEDOMETER AUTO UJULGE
DATEE FROM TO I READING a_ MILES Cd
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED PER MILE
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AUTO LICENSE NO, TOTALS J t 545
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby cerlffy that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
and that n art o yarn. j
Date I as been paid.
SEP
P&ESrRIBED BY STATE BOARD OF ACCOUNTS 1 I GENEA AL iOAN t10. Lal (1986]
MILEAGE CLAIM
(GOVERNMENTAL UNIT} v`•
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF, BOARD. DErAR M17 OR INSrRIR109)
SPEEDOMETER
D TE FROM TO I HEADING AUTO IAUAGE
Zp 4 POINT POINT START FINISH NATURE OF BUSINESS TRAVELED I
PER MILE
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AUTO LICENSE NO- TOTALS a
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map. 9 s
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, thai the amount claimed is legally due, after allowing all jus redits
end that no >t o1 e sa has been paid.
Date. 1 y vr1YL�
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.
359285 Simmonds, Valeska Terms
2703 E Lynn St Date Due
Anderson, IN 46016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8131111 Reimb Mileage 811 8130111 99.90
Total 99.90
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
i
Voucher No. Warrant No.
359285 Simmonds, Valeska Allowed 20
2703 E Lynn St
Anderson, IN 46016
In Sum of
99.90
ON ACCOUNT OF APPROPRIATION FOR
108 ESE'
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -4 Reimb 4343000 99.90 1 hereby certify that the attached invoice(s), or
bill(s) i$ (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
99.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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