HomeMy WebLinkAbout168876 02/17/2009 CITY OF CARMEN., INDIANA VENDOR: 361920 Page 1 of 1
4 ONE CIVIC SQUARE DAVID BITTELMEYER
s CHECK AMOUNT: $105.60
�..jo CARMEL, INDIANA 46032 8195 WESTFIELD BLVD
ro o INDPLS IN 46240 CHECK NUMBER: 168876
CHECK DATE: 2117/2009
DEPA ACCOUN PO NUMBER INVO NU AM DESCRIPTION
1.046 4343000 REIMB 105.60 'TRAVEL FEES EXPENSE
v
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL rQRM +O- ICI [1"6)
MILEAGE CLAIM
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(GOVERNMENTAL UNiTT ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE, HOARD, DEPARTDffTfr OB iNSRTlfIION)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO I READING MILES 6 j
24 C1 pOINT POINT START FINISH NATURE OF BUSINESS
TRAVELED PER MILE
M no Q' 0
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Li 4
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AUTO LICENSE NO. TOTALS
t -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 aliowing atI just credits
end that no part of the sa has been paid.
Date Z161
FEB 1 0 2009
ACCOUNTS PAYABLE VOUCHER
r CITY OF CARMEL
An invpice 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.
F%yee Purchase Order No.
361920 Bittelmeyer, David Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
216109 Reimb. Mileage 1!5109 2!6!09 CT 105.60
Total 105.60
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
2a�
Clerk- Treasurer
Voucher No. Warrant No.
Bittelmeyer, David Allowed 20
36192;0
In Sum of
ri
105.60
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 105.60 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
13 -Feb 2009
Signature
105.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund