HomeMy WebLinkAbout180230 12/08/2009 a F CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
w ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $45.42
r CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
INDIANAPOLIS IN 46208 CHECK NUMBER: 180230
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
1046 4343004 REIMB 45.42 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENARALFORM NO. 101 (1986)
MILEAGE CLAIM ..rRAveL PEQ MM 4b k0 001k-4345QD
n (GOVERNMENTAL uum 4 ON ACCOUNT OF APPROPRIATION NO. FOR 14 1 SF1'A T IT`1MP.t�1
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(OHICE, OARD. DE ART}O,urO,A OR INMTUM"
SPEEDOMETER
FROM TO AUTO NiLEAGE
DATE READING z
Q� NATURE OF BUSINESS M1L� t?.5�a
POINT POINT START FINISH 1.—M PEB MILE
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AUTO LICENSE NO.
TOTALS 5
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is eg lly due, after aliowing all just credits
and t at no part of the same has been paid.
i Date n`I/ 1 VI!✓
DEC G
BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
Terms
359461 Pittman, Nikeesha
Date Due
2713 Highland Place
Indianapolis, IN 46208
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
11/30109 Reimb. Mileage 11 /2 11125/09 45.42
Total 45.42
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of$
45.42
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343004 45.42 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
3 -Dec 2009
Signature
45.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund