HomeMy WebLinkAbout177211 09/15/2009 0 o. CITY OF CARMEL, INDIANA VENDOR: 363344 Page 1 of 1
0 ONE CIVIC SQUARE TYLER GOEDDE
CARMEL, IN 46032 CHECK AMOUNT: $26.40
s CHECK NUMBER: 177211
H `o
CHECK DATE: 9/15/2009
DEP ARTMENT ACCOUNT PO N INV OICE NUMBER AMO DESCRIPTION
1046 4343004 26.40 TRAVEL PER DIEMS
13 yq 3 (00q
P 00
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM tee, TO
(GOVERNMExTAL'uxtT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
FROM TO AUTO MILEAGE
D ATTE r�e
a Ova POINT POINT STAI ;TEADING F ASH NATURE OF BUSINESS MILES 55 a
TRAVELED PER MILE
l
Li
il 6 X10
AUG 26 ZU I
1 i
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distar.ce between poin 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 foregoin(i account is just and correct, that the amount claimed is legally due,, er allowing all just credits
2nd that no part of the same has .been paid.
7 3 6
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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.
Goedde, Tyler Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/31/09 Reimb. Mileage 6/26 7/24/09 26.4.0
Total
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.
Goedde, Tyler Allowed 20
In Sum of
7'
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 0� /�D 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
10 -Sep 2009
Signature
Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund