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HomeMy WebLinkAbout204971 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1 ONE CIVIC SQUARE DENEYSE SOLAZZO CHECK AMOUNT: $173.16 CARMEL, INDIANA 46032 14151 PEPIN PLACE CARMEL IN 46032 CHECK NUMBER: 204971 CHECK DATE: 12120/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 173.16 TRAVEL FEES EXPENSE PROSCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NC. 107 (1986) RO MILEAGE CLAIM o �e� Ls Lt (GOVERNMENTAL UNITI ON ACCOUNT OF APPROPRIATION NO. FOR (OFi10E, BOARD, DEPART ENT OR INSTYruTION) SPEEDOMETER AUTO AG� DATE FROM TO I READING MILES a NATURE OF BUSINESS ZD 1� 1 POINT POINT START FINISH TRAVELED PERK T C� 2- M CC_ 2`1 Mcc c M 0 3 t-kc_c to 1 r cC /u Fs TiA cc o L(. 1 0 'I L to 2 #A MtG 1 Z tAU I 1, M IsALL t 1 LL M.LL AUTO LICENSE NO. TOTALS Sp SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map Y edgits �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 ali end that no part of the same has been paid. Date J ell T 1. 1 Y DEC 9 5 2011 1 n. PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NG, 10) 0986] MILEAGE CLAIM TO A C 1 so \c C 0 (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OF210E, BOARD. DEPARTMENT OR 1NSTRUnON) FROM TO SPEEDOMETER READ READING DATE AUTO MILEAGE Za I— PONT POINT START FINISH PER MILE NATURE OF BUSINESS TRAVELED M CC t-- M cc TM L I it 1 1 TACC TK t 11 MCC 11 1 Ec- CC Il 2Z MCC 1 l I,,ICc i t 2 3 M� C- TrK iI 3r, ,titc C t 1 W i2 3 L l2 H MCC 1 I?- U YtCC 1 a tiCL I' 12- 6nC t r2 PA LC 12 10 MCC 1z' r W'C f Z i LL M i 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 part of the same has been paid. Date koo t EI" 5 2011 r L 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. 364715 Solazzo, Deneyse Terms 14151 Pepin PI Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 12/13/11 Reimb Mileage 9/27 12/13/11 173.16 Total 173.16 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. 364715 Solazzo, Deneyse Allowed 20 14151 Pepin PI Carmel, IN 46032 In Sum of 173.16 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE 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