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HomeMy WebLinkAbout204815 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365463 Page 1 of 1 ONE CIVIC SQUARE MATTHEW GREGORY CARMEL, INDIANA 46032 C/O ESE CHECK AMOUNT: $210.60 CHECK NUMBER: 204815 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 210.60 TRAVEL FEES EXPENSE DEC 0 8 2011 P P1 AtSCR1RCD Hr STATE BOARD Or ACCOUN75 }3 `7 0) 11900 GENERAL FORH RG. MILEAGE CLAIM U, UU r O r �1 TO CGOVEANMENrAL UNIn ON ACCOUNT OF APPROPRIATION NO. FOR tOHICE, BOARD. DEPARiICUfr OR MSMUTION) SPEEDOMETER AUTO EkGE 24DATE FROM TO READING f MILES Cd S• J NATURE OF HUSINE56 TRAVELED POINT POINT START FINISH TRAVELED MILE 3 J 0 1 y 1 I s 7 1 1 1 y O- L W i e A9 440 ors 7.7 o o I o s eT �s 7, a5- war p AUTO LICENSE NO. TOTALS k�v J -j O SPEEDOMETER READING columns are to be used only when distance between paints 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 just credits end that no part of the same has been paid. Dat J �l t DEC 3 2011 a:................... J a PRESCRIBED HT STATE BOARD OF AC OUNTS GENERAL FORM 110. 101 OWS) CL4 MILEAGE CLAIM t TO (GOVERNMENTAL UMT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTUWT OR IN3TT1W1ON} DATE FROM TO SREADIO�- AUTO S MILEAGE POINT 1 PORT START FINISH NATURE OF HUSINFS6 TRAVELED MME PER MILE QEAL F O 1 O CA 10 If-INA jAeLA- Z7 2V I PT zy air O a -4— P S' a.t D A/ r S vv /Voy bp I 'V W' N ti B V 1 1.1 4r 1 S` 1 7 IV P a 1 AUTO LICENSE NO. TOTALS Jf 1r ©S 3o SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. V 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 just credits and that no part of the same has been paid. Date Q t Pr T l r y 3 ?a11 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. 365463 Gregory, Matthew Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 10/13/11 Reimb Mileage 911 11/29/11 210.60 Total Is 210.60 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. 365463 Gregory, Matthew Allowed 20 In Sum of 210.60 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -7 Reimb 4343000 210.60 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 210.60 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund