HomeMy WebLinkAbout202247 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 365670 Page 1 of 1
ONE CIVIC SQUARE BAILEY NISH
CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $104.56
CHECK NUMBER: 202247
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 REIMB 104.56 TRAVEL FEES EXPENSE
GENERAL FORM NC. 101 (1986)
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPART@TT OR INSTTTUTION)
SPEEDOMETER AUTO AGE
DATE FROM TO I READING MILES
24 NATURE OF BUSINES6 1'AAVE ED P �SSS
POINT POINT STRRT FINISH
f Q
NACE TL 5o
1�- Tim 16
pc -Z1 Mbcv 3
7 8
ti 7 3
AUTO LICENSE NO. TOTALS I ►'J o�L I
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by lixed mileage or official highway map. l 0 4's 1
pW
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 :77W f the same has been paid.
i
Date
i
V�� r
S E P 201
09 1
t-
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.
Nish, Bailey Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/28/11 Reimb Mileage 5/31 7/28/11 104.56
Total 104.56
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
Voucher No. Warrant No.
Nish, Bailey Allowed 20
In Sum of
104.56
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1082 -1 Reimb 4343000 104.56 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
22 -Sep 2011
Signature
104.56 Accounts Payable Coordinator
Cost distribution ledger classification if f Title
claim paid motor vehicle highway fund