HomeMy WebLinkAbout170970 04/16/2009 1
CITY OF CARMEL, INDIANA VENDOR: 362074 Page 1 of 1
ONE CIVIC SQUARE NATALIE LOVE
CARMEL, INDIANA 46032 2470 CHASEWAY C7 CHECK AMOUNT: $59.33
iNDPLS IN 46268 CHECK NUMBER: 170970
CHECK DATE: 4/1612009
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESC
1046 4343004_. REIMB 59.33 TRAVEL PER DIEMS
z
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO, 101 (1%6)
MILEAGE CLAIM
TO f V
(GOVERNMENTAZ' T) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING
NATURE OF BUSINESS MILES e
POINT POINT START FINISH TRAVELED pER MILE
0im M606n ,n 4-e Je- t5 U' S
t. G C S
a K j _7 ACS
..7
r t ssss
Pb AA I i
1 �5
f� �S
lu
CC" P17
C
a A,4
v Is' f
CIA
Alp b I `i
AUTO LICENSE NO. TOTALS
SPEEDC)METIR 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 the foregoing account is just and correct, that the amount claimed is legal d e after allowing all just credits,
end that no part of the same has been paid.
Date
Y PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR IN871 10N)
FROM TO SPEEDOMETER AUTO MILEAGE
DA T E READING
NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED
PER MILE
G"
1
y
f,-
Ife lP
4>
C)
AUTO LICENSE NO. TOTALS
r
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 the foregoing account is just and correct, that the amount claimed is legally due, after all wing all just credits,
.znd that no part of the same has been paid.
D a €e
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.
Love, Natalie Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/25/09 Reimb. Mileage 12/02/08 2/20/09 59.33
Total 59.33
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.
�f'�1C�ut it- ?,&207q
Love, Natalie Allowed 20
In Sum of
59.33
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
j04(v Reimb. 4343004 59.33 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
8 -Apr 2009
&/C t,tY
Signature
59.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund