HomeMy WebLinkAbout169946 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 361054 Page 1 of 1
ONE CIVIC SQUARE CHARLES A IMAN
CHECK AMOUNT: $57.75
CARMEL, INDIANA 46032 11018 TAM O'SHANTER DR
CARMEL IN 46032 CHECK NUMBER: 169946
CHECK DATE: 3/1812009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NU J AMOUNT DESCRIPTION
1046 4343004 57.75 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM o
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READIME +R AUTO MILEAGE
MILES
19 POINT POINT START FINISH NATURE OF BUSINESS TRAVELED 5S x
PER MILE
6 t"(
r
G R iD T IAJ
F
I Yoe,
1i4 '7
D
D
AUTO LICENSE NO. TOTALS
11 06 1 6-
purchase
SPEEDOMETER READING columns are to be used only when distance between poi scr t be e' e or I eage or official highway map.
Pursuant to the provisions and penalties of'Chapter 155, Acts 1953, I hereby certify.adk o c� cc and correct, that the amount claimed is legally due f -after allowing all just credits
.end that no part o the same has been paid.
G.L. D
Date guddet
Line Descr j D�
Purchaser pate_ FEB 2009
APProval 3
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.
361054 Iman, Charles Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2127/09 Reimb. Mileage 1/5/09 1/30/09 57.75
Total 57.75
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Iman, Charles Allowed 20
361054
In Sum of
57.75
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 57.75 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
12 -Mar 2009
Signature
57.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I