HomeMy WebLinkAbout204780 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365676 Page 1 of 1
ONE CIVIC SQUARE JESSICA EVANS CHECK AMOUNT: $173.16
CARMEL, INDIANA 46032 C/O PARKS
o b' CHECK NUMBER: 204780
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 173.16 TRAVEL FEES EXPENSE
RR/SCRIBED BT STATE BOARD Of ACCOUNTS CTFHUAL FOAM lir M [INS)
MILEAGE CLAIM t
1GOVERNMEHrAL UNm T
ON ACCOUNT OF APPROPRIATION NO. FOR
CW,7trF. BOARD. DEPART EXT Oil t0griT T D l
FROM TO SPEEDOMETER AUTO WLEA=
DATE READWO t
POINT POINT START FINISH NATURE OF BU3iNE58 TRAVELED G. F r
PER lit
fD
e4 T"
TVA MAJ
WTI
AUTO LICENSE NO. —y— TOTALS l.J Y 90 i
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 1993, I hereby oertily that the foregoing account is just and correct, that the amount claimed is legally due, altar aliowing all lust credits
end thal no part of the same has been paid.
Date
3q3<)o
PRESCRIBED BY STATE BOARD OF ACCOUNTS GF"F.BAL FORK ]IG. ICl 09951
MILEAGE CLAIM p �S fi
(OOVERNNENTAL UNIT) ro
ON ACCOUNT OF APPROPRIATION NO. FOR
(CFF ICE, BOARD. DEPARTKEXr OR INSTMITIOMk
FROM TO SPEEDOMETER AUTO
�A.G
DATE I READING �Y
2 a POINT POINT START FINISH NATURE OF BUSINESS TR ES
D s
PER MILE
c� rX
PA N
1 0 TM
i
a
c
i
L I
CfM
Aur4 LICENSE No- r4rus
J
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 allowing all just credits
and that no part of the same has been paid.
Date
r`'`" f 2 2011
i� 3 A
�2
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.
365676 Evans, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1212111 Reimb Mileage 9/2 12/2/11 173.16
Total 173.16
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
365676 Evans, Jessica Allowed 20
In Sum of
173.16
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #FFITLE AMOUNT Board Members
Dept
1081 -9 Reimb 4343000 173.16 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
15 -Dec 2011
Signature
173.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund