HomeMy WebLinkAbout202059 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 365671 Page 1 of 1
ONE CIVIC SQUARE JOHN BRAKE CHECK AMOUNT: $23.58
CARMEL, INDIANA 46032 C/O PARKS
CHECK NUMBER: 202059
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 23.58 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS 1 GENERAL FORE 110, IN 09861
MILEAGE CLAIM
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
tOFi10E BOARD. DEPART@" OR visrn rTON)
SPEEDOMETER
FROM TO AUTO f MILEAGE
DATE READING
NATURE OF BUSINESS MILES QQ �Q c
2-� POINT POINT START FINISH TRAVELED PEA
I
Le-a
r e �Ltoc' i
e AUTO LICENSE NO. TOTALS e
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.(
a
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 dua ai er aliowing all just redits
end that no part of the same has been paid.
Date
i
SEP 0 9 20 i
1f tr:
sae...........
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.
Brake, John Terms
[nvoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7114111 Reimb Mileage 5131 7/14/11 23.58
Total 23.58
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
2p_
Clerk- Treasurer