HomeMy WebLinkAbout163812 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 357976 Page 1 of 1
�4•�. ONE CIVIC SQUARE BENJAMIN JOHNSON
s CHECK AMOUNT: $176.60
CARMEL, INDIANA 46032 8416 MANSHIP DRIVE
FISHERS IN 46038 CHECK NUMBER: 163812
CHECK DATE: 911712008
DEPAR ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 176.60 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENF. AL FORId NO. 101 (1986)
MILEAGE CLAIM
TO
ON ACCOUNT OF APPROPRIATION No. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
D FROM TO READING AUTO I�MAG�
IN T NATURE OF BUSINESS NffLES
POINT POINT START FINISH TRAVELED 11
MR MILE
&J L6
IA14 11 H
OW I C AA eW VJ
U Ut
kx--T h
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 penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally ter aliowing all just credits,
end that no part of the same has been paid.
Date
RECEWE-D
SEP 0 2 2008
BY:
o-7 71-
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1989
MILEAGE CLAIM
TO S
x
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF BOARD, DEPARTVENT OR INSTITUTION)
AUTO
SPEEDOMETER
DAT FROM TO i READING MILES MI E�4GE
ZQ NATURE OF BUSINESS
POINT POINT START FINISH TRAVELED PER MILE
I Lf/L=
lA'�
i(
t
I Zti-
i Ow el a C� II i
U 6
D
L -1-- °r-V P
MaNs+J-
r
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 legally ue, after aliowing all just credits
end that no part of the same has been paid.
Date 1 7�q
`1�.1C�.& V E D
S
EP 0 2 2008
BY:
qi.
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FOAM NO. 101 (i98r)
MILEAGE CLAIM
TO
(GOVERNMENTAL. UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DEPARTM_FNT OR INSTITUTION)
t^
FROM TO I' SPEEDOMETER AUTO MILEAGE
DAT 1 READING
z� POINT POINT START FINISH NATURE OF BUSINESS TRAVELED I
PER MILE
I
I i
�f V
AUTO LICENSE NO. 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.
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, afte liowing all just credits
is
and that no part of the same has been paid.
Date
TED
S E P 0 2 2008
BY:
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1985)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DEPARTMENT OR INSTITUTION)
DATE FROM TO READING SPEEDOMETER AUTO EAG
20 -a& POINT OF BUSINESS M (w E
POINT I POINT START FINISH TRAVELED t PER MILE
cN G tTE 1 k
1 ;ETf C NI?n L t
N 0 1
M�N�wi_ 11
I 1 MO&W CT/L li
miu 1 MA&N) C- at--%4 "W
.jog
t.
AUTO LICENSE NO. TOTALS 3Q O
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 1
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 legal 'due, after allowing all just credits
and that no part of the same has been paid. g�
Date C IN7 illJ
R
SEP 2 2008
BY
r
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.
Ben Johnson Terms
8416 Manship Dr Date Due
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/2/08 reimb. Mileage 1/9/08 8/29/08 176.60
Total 176.60
I 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
�4.
i
Voucher No. Warrant No.
Ben Johnson Allowed 2p
8416 Manship Dr
Fishers, IN 46038
In Sum of
176.60
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO #r INVOICE NO. ACCT #/TITLE AMOUNT Board Mer�tb
U �rs
P
1046 Reimb 4343000 176.60 1 hereby certify that the attached invoi,e(S) or
bill(s) is (are) true and correct and that th
materials or services itemized therepn for
which charge is made were ordered and
received except
2 -Sep 2008
Signature
176.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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