HomeMy WebLinkAbout172759 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY BUCKINGHAM CHECK AMOUNT: $108.90
CARMEL, INDIANA 46032 5130 PRIMROSE AVE
INDIANAPOLIS IN 46205 CHECK NUMBER: 172759
CHECK DATE: 5/27/2009
D EPA R TMEN T AC PO N UMBE R INVOI NU MBER AMOUNT DESCRIP
1046 4343004 REIMB 108.90 TRAVEL, PER DIEMS
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PRISCRISED B7 STATE BOARD OF ACCOUNTS GENERAL FORM 1 +0. 10) 119867
MILEAGE CLAIM
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SPEEDOMETER
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DAT READING
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POINT POINT START FINISH TRAVELS. PER
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TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after atiowing all just credits
and that no part of the same has been paid.
Date
i
MAY 1 3 2009 �0
BY:
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
1 Purchase Order No.
358408 Buckingham, Tiffany Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/1109 Reimb. Mileage 3/16/09 4/30/09 108.90
Total 108.90
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
358408 Buckingham, Tiffany Allowed 20
In Sum of
108.90
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 108.90 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
21 -May 2009
Signature
108.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund