HomeMy WebLinkAbout169838 03/18/2009 E CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: $142.94
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
'tiy� �o. r NOBLESVILLE IN 46060 CHECK NUMBER: 169838
CHECK DATE: 3/18/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1046 4343004 92.94 TRAVEL PER DIEMS
1046 4359000 50.00 SPECIAL PROJECTS
I
PRLSCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1985)
MILEAGE CLAIM
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OiiICE, HOAAD, DEPARTMr71T OP IN"T[TUTION)
SPEEDOMETER
FROM TO READING AUTO N.II
DATE
4 NATURE OF BUSINESS MILES
L� POINT POINT START FINISH TRAVELED PER MILE
r\ n S
t o
r\ O
i'1'V� Y1
f n.
c L
1•
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. 119 1 q H
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 aliowin is
end that no part of the same has been paid.
Date _tz purchase 1W p or F
1 000 00,00
B
LineDesc pate----'� FEB 7 2009
purchaser Date
APProval ,V.
PRPSCKMED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 10) (1906)
MILEAGE CLAIM
ro �'i A ,l
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OF7)CE, BOARD, DEPARTMENT OR )NSRTUTION)
SPEEDOMETER AUTO MILEAG
DATE FROM TO READING NATURE OF BUSINESS MILES J c
Za POINT MINT START FINISH
TRAVELED PER MILE
1T n
r� riL r
L
�f c L-)
Z) CGre -t
T k n AD
n
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AUTO LICENSE NO. TOTALS co c 3
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 for account is just and correct, that the amount claimed is legally due, after allowing all just credits
end tha no part of the same has been paid. �t
Date �C I J purchase p or F
1 Description
p.O. O0o
G.L.
Bud 96t F
D
Line escr Date_.i
purchaser Date 2 F E 2 7 2009
Approval
�A
pct 4. O�
C, a98 ow Extended School Enrichment
Employee Referral Pro2ram 1046:4359000
PPp�
ESE Employee: Start Date of Referral: Bonus Amount:
Name of Referral: ESE School Site:
J OE
E Employee Signature Date
E Manager Signature Date
Extended School Enrichment
Employee Referral Program 1046:4359000
ESE Employee: Start Date of Referral:
Name of Referral: ESE School Site:
�L
/a C)
ESE m ee. Signature Date
ESE Division Manager Signature Date
Purchase
Descriptio
P.O.# PorIF
G.L. 1e0�00 LI 11 lL'oo
Budget
Line eV AA
Purchaser ate
Approval Date, -o
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.
360144 Canada, Cyndi Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/27/09 Reimb. Mileage 12/1/08 2/13/09 92.94
2/25/09 Referral Dawn Armbruster Employee Referral 25.00
2/25/09 Referral Melissa Jenniges Employee Referral 25.00
Total 142.94
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.
360144 Canada, Cyndi Allowed 20
In Sum of$
142.94
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 92.94 1 hereby certify that the attached invoice(s), or
1046 Referral 4359000 25.00 bill(s) is (are) true and correct and that the
1046 Referral 4359000 25.00 materials or services itemized thereon for
which charge is made were ordered and
received except
12 -Mar 2009
Signature
142.94 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund