HomeMy WebLinkAbout176408 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA KARSAS
15439 HARMON PLACE CHECK AMOUNT: $32.45
CARMEL, INDIANA 46032
y .off is NOBLESVILLE IN 46060 CHECK NUMBER: 176408
CHECK DATE: 8119/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
^x.1046 4343004 REIMB 32.45 TRAVEL PER DIEMS
Z
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION 110. FOR W' ►4� V Y V L.L J
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READ G AUTO MILEAGE
110 CY POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
vY) 2,
o D O) :3 0
t 1
-;p
im n i o
Pax 2.0.
MOO" AAMP el
E3 i L Z O O
N ar
1 D
c� 2 D
5 01 F, 1V1 O V} (7�tA� MS_Sil�►1� D
.3 Foe
a D
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AUTO LICENSE NO. TOTALS
SPEEDOMETER READI 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 allowing all just credits,
2nd that no part of the same has beer. paid.
1
Date j I 00 1
1
i
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, b
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Y
Payee
361801 Karsas (Reynolds), Alyssa Purchase Order No.
Terms
Invoice Invoice
Date Number Description
(or note attached invoice(s) or bill(s))
5/29/09 Reimb. Mileage 5/1/09 5/29/09 PO Amount
32.45
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance o al 32.45
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
i
Voucher No. Warrant No.
361801 Karsas (Reynolds), Alyssa Allowed 20
In Sum of
32.45
l�
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 32.45 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
13 -Aug 2009
Signature
I s 32.45 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund