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HomeMy WebLinkAbout156823 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 360411 Page 1 of 1 ONE CIVIC SQUARE- AARON SMITH CARMEL, INDIANA 46032 9773 SAN MARCO PASS CHECK AMOUNT: $76.53 INDIANAPOLIS IN 46280 CHECK NUMBER: 156823 CHECK DATE: 2/21/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1046 4343000 76.53 TRAVEL FEES EXPENSE �r PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966) II kzu I D `1.. MILEAGE CLAIM nn JAN 1 8 200 DEPT TO— (GOVERNMENTAL UNIT) I 11 ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) DE U SC T�aVel Fees FROM TO SPEEDOMETER AUTO MILEAGE DATE READING NATURE OF BUSINESS MILES 0 POINT POINT START FINISH TRAVELED PER MILE M -B I Z 3 R r 9 A i z ��Y... o� G z zu itil S? C t,,, w AUTO LICENSE NO. TOTALS 1 5 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 1''e9 due, alter allowing all just credits and that no part of the same has been paid. Date /b6 i 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 o tr' a p rs w� a (0 y N p n Allowed 19__ m 6 a_ n M M in the sum of b m o a m a. tr M m w o o m M m O- A O n `C (~.D (Board or Commission) o n R. m a oa FILED M rt n M rt y m a (Official Title) O a to C fD N N �yy b qq p tr• N• A.E. BOYCE CO., INC. MVNCIE, IN 01136 t Q+ 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. Aaron Smith Terms Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/17/08 reimb. mileage reimbursement 76.53 Total 76.53 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. Aaron Smith Allowed 20 In Sum of 76.53 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 reimb. 4343000 76.53 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 13 -Feb 2008 r Sig tur 76.53 Business Sery Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund