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Home My WebLink About206810 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 359285 Page 1 of 1 p ONE CIVIC SQUARE VALESKA SIMMONDS CHECK AMOUNT: $142.49 CARMEL, INDIANA 46032 2703 E LYNN ST ANDERSON IN 46016 CHECK NUMBER: 2,06810 CHECK DATE: 212812012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 142.49 'TRAVEL FEES EXPENSE PRESCRIBED BY STATE BOARD OF ACCOUNTS �al�s�� S(DMQIJ5 GENERAL FOR11 NO. 101 11786] MILEAGE CLAIM (GOVONNENrAL UN1I] ON ACCOUNT OF APPROPRIATION NO. FOR (OFeICE, BOARD, DEEAAT1UWE OR INSr=108) SPLEDOMETFR AUTO l4ILEAGE DATE FROM To I READING NATURE OF BUSINESS MILES (Q 2 POINT POINT START FINISH TRAVELED PER WU _l. Q 1- r r r� f 1 AUTO L TOTALS ICENSE NO. 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 t e loregoing account is just and correct, that the amount claimed is legal] ue, after aliow' all just credits r and th t 8q of the s Is has been paid. Date I 0 T3 an FEB 1 3 1011 OV ��a PRESCRIBED BY sTATr BOARD Oi ACCOUNTS GERF.RAL rOAY 11C_ 101 (19667 MILEAGE CLA OQ La- U M y /t S (GOVERNMENTAL U11I17 ON ACCOUNT OF APPROPRIATION NO- FOR tOFME, BOARD, DEF"TY1FKr OR IN rMMOX) SPEEDOMETER DATE FROM To READING AUTO MMEAGE NATURE OF BUSINESS POINT POINT START FINISH TRAVELED PER MILE Fccrr4 'I ts_ TtllraQ4 M 1 3— r(c. LC. mC� �G C LL CC CC m MCC fl —t 4 AUTO LICENSE NO- TOTALS 1 t 5 t t SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway. map. 4 4— 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 allowing all just credits and that no part of the same has been paid. Date L 4 PRESCRIBED 8T STATE BOARD OF ACCOUNTS 1 CERT.RAL FORM NG. ICI {19867 MILEAGE CLAIM Tp I St yyy (GOVERRUENTAL UNI'n ON ACCOUNT OF APPROPRIATION NO. FOR COMM SOARS, DE "tF6'XT OA INSrM- rr10N) SPEEDOMETER AUT t1tLF IxG DA FROM TO TE i READING O NATURE OF BU SINES Q, S ttILES POINT PODVT START FINISH TRAVELED PER 14LE GC c: sit M MLZ fn C t c 'P MCC 7 10 1E Vh 1 cL i r.z- C.C.. L AUTO LICENSE NO- TOTALS SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. t�F'ti LIJ 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 and that no art of the same has been paid. 11 It Date 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. 359285 Simmonds, Valeska Terms 2703 E Lynn St Date Due Anderson, IN 46016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 2/6/12 Reimb Mileage 11/16/11 2/6/12 142.49 Total 142.49 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 i Voucher No. Warrant No. 359285 Simmonds, Valeska Allowed 20 2703 E Lynn St Anderson, IN 46016 In Sum of$ 142.49 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -4 Reimb 4343000 142.49 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 23 -Feb 2012 Signature 142.49 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund