HomeMy WebLinkAbout180042 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 359554 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL ETHRIDGE CHECK AMOUNT: $126.50
CARMEL, INDIANA 46032 8821 GANTON COURT
INDIANAPOLIS IN 46234 CHECK NUMBER: 180042
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRIPTION
1046 4343004 126.50 TRAVEL PER DIEMS
PRESCRIBE1311T STATE BOARD OF ACCOUNTS 1 GENFAAL FOR1111o. 101 (19U)
MILEAGE CLAIM
TO
tGOVERHMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO- FOR
(6Fi7C8, BOARD, DEPARTMENT OR INSTnUrION)
$PEEDOMETFR
DATE FROM TO E READING AUTO WMLGE C
NATURE OF BUSINESS
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SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 1026 ZR I
Pursuant to the provisions and penalties of Chapter 155, Acts 1853, I hereby certify that the toregoing 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
4 "10 o
1
Em
NOV 1 9 2009
ACCOUNTS PAYABLE VOUCHER
j. 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.
Ethridge, Crystal Terms
8821 Ganton Ct
Indianapolis, IN 46234
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/19/09 Reimb. Mileage 8/3/09 10/2/09 126.50
Total 126.50
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
P
Voucher No. Warrant No.
Ethridge, Crystal Allowed 20
8821 Ganton Ct
Indianapolis, IN 46234
In Sum of
126.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1046 Reimb: 4343004 126.50 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
126.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund