HomeMy WebLinkAbout168776 02/05/2009 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1
ONE CIVIC SQUARE PAMELA GRIFFITHS
r CHECK AMOUNT: $35.10
CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 168776
CHECK DATE: 2/512009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
=1202 4343002 35.10 EXTERNAL TRAINING TRA
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING NATURE OF BUSINESS MILE 5 0
19 POINT POINT START FINISH TRAVELED PER MILE
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(J G A
3 c� GG u 3 w
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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
and that no part of the same has been paid.
Date �LI 1
Claim No Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
PO4 r That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o tr• w
a� a
is p
w m o 0
m m
p n
Allowed 19 ID w
m K m
in the sum of b m
y
w
m w tr
CL
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y (D
O. o
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(Board or Commission) 0
CL cD rt
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(Official Title) O O
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 k o 0
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM
5 A (J AM TO
(GOVERNMENTAL vxrr) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER AUTO MILEAGE
DATE FROM To READING NATURE OF BUSINESS MILES �jQ C
19 POINT POINT START FINISH TRAVELED PER MILE
Q C z r W Alr%t. Gi 1
I
n 0 1 G�V i c; 6, Gt GL GG I r /4 V 0 t7 ar
f t 16 6AX aV&
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'vf 61
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6 C CcG 3 i 5rwIE5 Ivid a V1 L
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6 C C- 6 r v v,
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C E C4 qtA
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 accour_# is just and correct, that the amount claimed is le a after allowing all just credits
and th o part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
1
fl That it is in proper form.
That it is duly uthenticated as r
Y q
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
C p
m
n l g
:allowed 19_
in the sum of I m
w
(0 m M
r a
m
0
n �e ':1
(Board or Commission) a
CD
FILED
CA
rt n M
m w
;Z. rA
LA
(Official Title) o 0 W
<m.
m
A.S. SOYCE CO., INC. MINCIS, IN 01136 t
i' j
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Pam Griffiths Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/0
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 InJQ24WWARRANT NO.
Pam rl I S ALLOWED 20
IN SUM OF
$7020
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1202 Information Systems
Board Members
PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1202 0 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
20
Signa
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund