HomeMy WebLinkAbout156806 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 354943 Page 1 of 1
ONE CIVIC SQUARE REBECCA A SCHMIESING
CARMEL, INDIANA 46032 9135 DRYANT LANE #2B CHECK AMOUNT: $40.83
INDIANAPOLIS IN 46250
CHECK NUMBER: 156806
CHECK DATE: 2121/2008
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DESCRIPTION
1125 4343000 40.83 TRAVEL FEES EXPENSE
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i
Carmel 0 022 JAN
Parks Recreation 2 2 20Q8
Employee Expense Reimbursement Request
Date of
Receipt Vendor listed on receipt Fund Department Account Line Account Description Amount Purpose of Expense
TaVel Fin 9�, l uru c_h
All receipts should be attached in the same order as listed above.
TOTAL 7 J 7 5 FS
Name (print)
Check Address C Ire
payable to: 2 '1
City, St, Zip w lZJ��6 4 (DD94
Signature �Pj pw�( Date: CD fl�
Approved by: ,rx� Date:
Revised 3 -2 -07 by Business Services
PRESCRIBED BY STATE BOARD OF ACCOUNTS JAN 2 2008
GENERAL FORM NO. 101 (1986)
2
MILEAGE CLAIM
TO
n Lem I� M
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) E SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING NATURE OF BUSINESS MILES
19 POINT POINT START FINISH TRAVELED PER MILE
�l�f 8 rS e J�rJ'non( Irk 1793s� 7- 53.5 ,S. S
r co n oN Cer1 NFL s 3. s 1 796 9 o s. 7,
IN
D 3 1
i
AUTO LICENSE NO. TOTALS /s
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
.end that no part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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in the sum of
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(Board or Commission) 0 rt
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(Official Title) o K
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 (D
1Q 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.
Rebecca Schmiesing Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/17/08 Reimb Req Mileage 15.65
1/16/08 Reimb Req Conference expenses 25.18
Total 40.83
1 hereby certify that the attahced 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.
Rebecca Schmiesing Allowed 20
In Sum of
40.83
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb Req 4343000 40.83 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
12 -Feb 2008
i ature
40.83 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund