HomeMy WebLinkAbout172013 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA REYNOLDS
CHECK AMOUNT: $45.10
CARMEL, INDIANA 46032 11410 BURKWDOD DRIVE
CARMEL IN 46033 CHECK NUMBER: 172013
CHECK DATE: 4/29/2009
.!D EPARTMEN T ACCOUNT PO NUMBE INVOICE NUM AMOUNT D ESCRIPTION
1046 4343004 REIMB 45.10 TRAVEL PER DIEMS
PRESCED �j{ (�COLi1�T S I GENERAL FORM NO. 101 (1986)
li f !l U �U�J c� i
9
MILEAGE CLAIM
BY:.. I TO
(GOVERNMENTAL vNM ON ACCOUNT OF APPROPRIATION NO. ?OR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER.
DATE FROM TO READING AUTO MILEAGE
NATURE OF BUSINESS MILES 5 5 D x
0 r���} POINT POINT ST;UT FINISH TRAVELED PER MILE
,o
Pi) E
`3 ff WA
q Cl 3 D
3 Pb G I 3.
i
P
U O
3 Work
3 3 3
2
2 l 3,
WMA r0
3 I 3a
:3 n e, Mf1 3
AUTO LICENSE; NO, TOTALS
SPEEDOMETER READING columns are: o 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 forecloing account is just and correct, that the amount claimed is i egally due, after allowing all just credits
-and that no part of the same has been paid.
l
ACCOUNTS PAYABLE VOUCHER
1 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
361801 Reynolds, Alyssa Purchase Order No.
Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO
Amount
3/31/09 Reimb. Mileage 3/2/09 3/31/09
45.10
Total 45.10
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.
361801 Reynolds, Alyssa Allowed 20
In Sum of
45.10
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 45.10 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
22 -Apr 2009
Signature
45.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund