HomeMy WebLinkAbout176110 10/14/2009 CITY OF.CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
�s 0 ONE CIVIC SQUARE MEAGAN DECKER
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CARMEL, INDIANA 46032 CHECK AMOUNT: $91.96
CHECK NUMBER: 176110
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CHECK DATE: 10/14/2009
DEPARTMENT ACC OUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
r 1046 4343004 REIMB 91.96 TRAVEL PER DIEMS
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GW..PAL FORM NC. 101 (IN6}
TO L MILEAGE CLAIM
(GOVERNMENTAL "M ON ACCOUNT OF APPROP L ITION NO, FOR
(OF, BOARD, DEEARTIM" OR INSTiTlnION)
FROM TO SPEEDOMETER AUTO E
DATE I READING t
20 POINT POINT START FINISH NATURE OF BUSINESS MILES C1 S
TRAVELED PER WLE
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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 cartify 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
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O C f G 6 2009
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.
363382 Decker, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/30/09 Reimb. Mileage 9/1 9/30/09 91.96
Total 91.96
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.
363382 Decker, Meagan Allowed 20
In Sum of
91.96
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 91.96 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
7 -Oct 2009
Signature
91.96 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund