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HomeMy WebLinkAbout204003 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 364943 Page 1 of 1 ONE CIVIC SQUARE VICKI RUBIO CHECK AMOUNT: $78.07 CARMEL, INDIANA 46032 "k rod CHECK NUMBER: 204003 CHECK DATE: 11/21/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 78.07 TRAVEL FEES EXPENSE GENT.RAL FORM NC.]C-0 (19861 pxeSCRIBit) BY STATE BOARD Or ACCOUNTS MILEAGE CLAIM "n` y .NtALUNITI ON ACCOUNT OF APPROPRIATION NO. FOR I0r}7CE, BOARD. EP&an6 17 OR INS rTUTION) FROM TO S ER A UTO AEL�EAG7E DATE NATURE OF BUSINESS TRAVELED Za POINT POINT START FINISH PER MILE Gam` I t I ib U 14 A O a it. -tt �9 MCC, S e t C. I' 1 AUTO LICENSE NO- TOTALS l S SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is le ally due, after 'owing all just credits r end that no part of the same has been paid_ Date TM �'M %7 TV J ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 364943 Rubio, Vicki Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 10/31/11 Reimb Mileage 1013 10/31/11 78.07 Total 78.07 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 1 20 Clerk Treasurer Voucher No. Warrant No. 364943 Rubio, Vicki Allowed 20 In Sum of$ 78.07 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members Dept 1081' -3 Reimb 4343000 78.07 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 17 -Nov 2011 Signature 78.07 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund