HomeMy WebLinkAbout177752 09/29/2009 CITY Of CARMEL, INDIANA VENDOR: 352074 Page 1 of 1
ONE CIVIC SQUARE NATALIE LOVE CHECK AMOUNT: $109.67
CARMEL, INDIANA 46032 2470 C IN Cr
CHECK NUMBER: 177752
CHECK DATE: 9/29/2009
DEPARTME ACCOUNT PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
1046 109.67 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILE GE
DATE READING NATURE OF BUSINESS_
19 POINT POINT
START FINISH TRAVELED
PER MILE c
C 3
o
N_ o b' L z
yn I A
cp
22
Mc
NO
3
Z
o
a1
Mr
1
AUTO., LICENSE NO. TOTALS
SPEEDOMETER BEADING columns are to be used only when distance between points 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
and that no part of the same has been paid,
Date
�R
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO, 101 (1986)
MILEAGE CL.KINS
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
BATE FROM TO S REA ED ING +R AUTO MILEAG
NATURE OF BUSINESS, MILES (d 0
O1 POINT POINT START FINISH TRAVELED --4 MILE
MC
TGl d Z
L
J
GCD 0t 3.3 0
M 0 E2
M c_.
r
EP 0 3 2 009 I
AUTO LICENSE NO. TOTALS
ll v lJG
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or Official highway map, a�
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing accotuit is just and.corr ct, that the amount claimed is legally due, after' ovAng all just credits,
znd that no part of the same has been paid. �r
Date 0000 i 300
y -1A 3 glzloq
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.
362074 Love, Natalie Terms
1f
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
913109 Reimb. Mileage 7113 912/09
1 09.67
Total 109.67
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,
362074 Love, Natalie Allowed 20
In Sum of
4 109.67
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 109.67 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
24-Sep 2009
Signature
109.67 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund