HomeMy WebLinkAbout203389 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
i CHECK AMOUNT: $138.19
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
a NOBLESVILLE IN 46060 CHECK NUMBER: 203389
CHECK DATE: 11/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 138.19 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM NG. 101 (1496)
MILEAGE CL
IGOVEANNENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPAATMMff OR INSTRVTION)
SPEEDOMETER
DATE FROM TO I READING NATURE OF BUSINESS MILES a c
POINT POINT START FINISH TRAVELED PEAS
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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, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowing all just credits
end that no art p
of the same has been aid.
11�
Date
r
y 1 2011 j
PRFSCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110. 191 119867
MILEAGE CLAIM
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(Of BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS MILES !CrC t
POINT POINT START FINISH TRAVELED PEA
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AUTO LICENSE NO. TOTALS
u
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 allowing all just credits
end thn� tno perrt th1s has been paid.
Date jn) I I C
C €r l 2011
PRESCRIBED BY STATE BOARD Or ACCOUNTS GENERAL FORM 110. 101 (1986)
MILEAGE CLAIM
TO
1
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF110E, BOARD, DEPARTLUXT OR )NSTlMiON)
SPEEDOMETER
2 DA'KE FROM TO I READING AUTO
d POINT POINT START FINISH NATURE OF BUSINESS TRAVELED C .a
PER MILE
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ry"
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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, 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 no art of t1 ale has been paid.
Date 10
nfI �l
J 0� p 2 1 10 11
f
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/18/11 Reimb Mileage 8/2 10/18/11 98.12
10/18/11 Reimb Mileage 7/11 7/29/11 40.07
Total 138.19
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of
138.19
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 98.12 1 hereby certify that the attached invoice(s), or
1082 -2 Reimb 4343000 40.07 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
3 -Nov 2011
Signature
138.19 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund