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HomeMy WebLinkAbout177125 09/15/2009 CITY OF CARMEL, INDIANA VENDOR 358408 Page 1 of 1 z ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $164.45 CARMEL, INDIANA 46032 5130 PRIMROSE AVE 4; row a INDIANAPOLIS IN 46205 CHECK NUMBER: 177125 a CHECK DATE: 911512009 DEPA RTMENT AC P NUMBE INVOICE NUMBER AMOUNT DESCRIPTION 104.6 4343004 164..45 TRAVEL PER DIEMS PRESCRIM ET STATE 60ARE) OF ACCOUNTS GENERAL FORM NO. 101 (10861 MILEAGE CLAIM (GOVFANMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFYICE. BOARD. DEPART KIM OR INSTlTV71ON1 r SPEEDOMETER FROM TO ji SPEEDOMETER i AUTO I MILEAGE za MILES C NATURE OF BUSINESS l POINT POINT START FINISH TRAVELED €i PER MILE E z c, I l l E O 11 CIT 0 o Y1 O E j 'e G C 3 O IZ C -j MO✓1CV� C .T AUTO LICENSE NO- TOTALS VI U SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. t lll!lllll Pursuan! 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 all just credits and that no part of the same has been paid. Date J o� -7, AUG 2 6 2009 1. x� ACCOUNTS PAYABLE VOUCHER r 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. Terms 358408 Buckingham, Tiffany 5130 Primrose Ave Indianapolis, IN 46205 Invoice Invoice Description PO Amount Date Number (or note attached invoice(s) or bill(s)) 164.45 8126/09 Reimb. Mileage 5129 8112109 Total 164.45 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. 358408 Buckingham, Tiffany Allowed 20 5130 Primrose Ave Indianapolis, IN 46205 In Sum of �v 164.45 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members Dept 1046 Reimb. 4343004 164.45 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 10 -Sep 2009 Signature 164.45 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund