HomeMy WebLinkAbout203087 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 361086 Page 1 of 1
ONE CIVIC SQUARE JACOB C MOORS
CARMEL, INDIANA 46032 348 ATHERTON DR CHECK AMOUNT: $38.39
CARMEL IN 46032
roe CHECK NUMBER: 243087
CHECK DATE: 10/2512011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 38.39 TRAVEL FEES EXPENSE
FRRSCRIEED BY STATE HOARD OF ACCOUNTS GrNFRXL FOAL NO. ]QI 0986)
MILEAGE CLAIM
TO J CkCO A06 "re
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(Off ICE, HOARD. DEPARTMENT OB 1NSTMJTION)
T SPEEDOMETER
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f AUTO
DATE FROM TO READING t l�
Zo POINT POINT START F1N[SH NATURE OF BUSINESS htVEL PER r
]'RAVELED
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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 aliowing all lust credits
end that no part of the same has been paid.
Date
OC7 i
L
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.
361086 Moore, Jacob Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10114/11 Reimb. Mileage 9114 10/14/11 38.39
Mileage 819 9/13/11
Total 38.39
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.
361086 Moore, Jacob Allowed 20
In Sum of
38.39
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -1 Reimb. 4343000 38.39 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
20 -Oct 2011
Signature
38.39 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund