HomeMy WebLinkAbout202220 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 364478 Page 1 of 1
ONE CIVIC SQUARE SARA MCMULLEN
1 CHECK AMOUNT: $8.88
i•.,�� CARMEL, INDIANA 46032 10911 VALLEY FORGE CIRCLE
CARMEL IN 46032 CHECK NUMBER: 202220
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION
211 4462838 8.88 STORM WATER PHASE II
Prescribed by State Board of Accounts General Form No. 101 (1955)
MILEAGE CLAIM n
t o C TO1� l l���QiV�i DR.
(Governmental Unit
v1 On Account of Appropriation No. 4�_ 2 20 0 for T Yo--ye
ffice, Board, Utipartment or Institution)
DATE FROM TO ODOMETER READING" NATURE OF BUSINESS AUTO MILES MILEAGE S
20_LI Point Point Start Finish TRAVELED PER MILE
m- 1002 S `00.1,01 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, 1 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.
Date Q�2lo 1 l 1
Clcam No, Warrant No. 1 have examined the within claim and
hereby certify as follows:
IN FAVOR OF
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
On Account of Appropriation No. for
Disbursing Officer
(Q C�
Allowed 20 o
in the sum of O n
(D
0, C1m
ro a CD
(D
m
(Board of commission) o
m
FILED o
End'
o o
o
Q m
CD m
cn
f�
(Official Title)
(D
0
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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
CNIVOL IM�11�1� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
20
f
S nature
on
_-�I -C V,"
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund