HomeMy WebLinkAbout202816 10/12/2011 CITY OF CARMEL, INDIANA VENDOR: 364750 Page 1 of 1
ONE CIVIC SQUARE JESSICA BALLINGER
CARMEL, INDIANA 46032 10830 TOOLEY CT CHECK AMOUNT: $115.44
APT IF
CHECK NUMBER: 202816
INDIANAPOLIS IN 46234
CHECK DATE: 10/12/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 115.44 TRAVEL FEES EXPENSE
PRPSCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NG. 101 (1986)
MILEAGE CLAIM
TO
ON ACCOUNT OF APPROPRIATION NO. FOR
(Oii tCP, BOARD, DEPAATMETfr OA INSTTTUIlox)
SPEEDOMETER
DATE FROM TO READING .t- AUTO MIL�IGE
241L_ POINT POINT START FINISH NATURE OF BUSINESS TRAVELED P
PER MILE
E. +C f0 d-
T I cc V
wcc c
C- d P tS U
L" �1 t Yo I (A i
.c
1 1 4 Lt
t� L- O
LL 14o
1.1 140
4 q0
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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits
and that no part of the same has been paid.
Date t l 3
f q 3 VOkq
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.
364750 Ballinger, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/30111 Reimb Mileage 8/8 9/12/11 115.44
Total 115.44
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.
364750 Ballinger, Jessica Allowed 20
In Sum of
115.44
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -10 Reimb 4343000 115.44 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
i
6 -Oct 2011
6 �M�
Signature
115.44 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i