HomeMy WebLinkAbout163389 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 358895 Page 1 of 1
ONE CIVIC SQUARE KELSEY SCHULZ
CARMEL, INDIANA 46032 5684 OTTAWA PASS CHECK AMOUNT: $25.97
o CARMEL IN 46033
CHECK NUMBER: 163389
CHECK DATE: 9/3/2008
DEPARTMENT ACCOUN PO NUMB I NUMBER AMOUNT DESCRIPTION
1046 4343000 25.97 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM No. 101 (1966)
MILEAGE CLAIM
TO l
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS MII�S MILER 5 v g
19 POINT POINT START FINISH TRAVELED
ER MILE
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4
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AUG I
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AUTO LICENSE NO. TOTALS
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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 allowing all just credits
.and that no part of the same has been paid.
Dade i 7 z
IF
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.
Schulz, Kelsey Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/11/08 Reimb. Mileage 8/4/08 8/7/08 25.97
Total 25.97
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Schulz, Kelsey Al!owed 20
If
In Sum of
25.97
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE N0. ACCT #/TITL AMOUNT Board Members
Dept
1046 Reimb. 4343000 25.97 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
18 -Aug 2008
Signature
25.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund