HomeMy WebLinkAbout204401 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN STORMS
0 CHECK AMOUNT: $91.96
CARMEL, INDIANA 46032
CHECK NUMBER: 204401
CHECK DATE: 12/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 91.96 TRAVEL FEES EXPENSE
PRESCRIBED 87 STATE BOARD OF ACCOUNTS GENERAL FORM 1;0. 10l 114863
MILEAGE CLAIM
TO
tGOVEANl1ENrAL UNIT}
ON ACCOUNT OF APPROPRIATION ND. FOR
toyncr, BOARD. D EPARTuaxT on 1NsTrnrnoN)
SPEEDOMETER DATE FROM TO READ NG AUTO AGE
2� PONT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
.04 j
1' W 7 1 n S
PT" q 1 0
bJ Sc I ft 0 io VVI non &/1 s c v.
�f v 1 r2
P
F
3 1 o
7il VT n �1 a
ob L4 Z 37
3 0
VV Jig �e i t
v,57-
oo 7.
AUTO] LICENSE NO. TOTALS 1 C4
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 1
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 atiowing all just credits
end that no pail of the same has been paid.
Date
`1 o �{t NOV 3 0 1011 t�
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.
363382 Storms, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/30/11 Reimb Mileage 11/1 11/30/11 91.96
Total 91.96
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.
363382 Storms, Meagan Allowed 20
In Sum of
91.96
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -7 Reimb 4343000 91.96 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
1 -Dec 2011
Signature
91.96 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund