HomeMy WebLinkAbout171066 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 362100 Page 1 of 1
ONE CIVIC SQUARE PAULA SCHLEMMER
CHECK AMOUNT: $23.65
CARMEL, INDIANA 46032 9455 CANOPY LANE
FISHERS IN 46036
CHECK NUMBER: 171066
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE N UMBER AM OUNT DESCRIPTION
1125 4343004 23.65 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 tI5E6)
MILEAGE CLAIM PAULA
TO_
AIZM>t L �i �1y Pq i2�CS Ahl R al:� l I QN
(GOVERNMENTAL UNIT*
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE. BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO I READIOM AUTO MIL$A E
qA 7—+ NATURE OF BUSINESS MILES Q o f C
POINT POINT START FINISH TRAVELED PER MILE
t? TRUST EE- _QF01__.__ TL)12r7 6 `l
1 4 A. 0. FC 11 _E- S
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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.
Pursuant to the prowisions.and penalties of Chapter 155, Acts 1953 I hereby certify that the foregoing account is just and correct, that the amount claimed is leg ly due, after allowing all just credits
and that no part of the same has been paid.
Date
APR 0 6 2009
BY-
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.
362100 Schlemmer, Paula Terms
9455 Canopy Lane
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/26/09 Reimb Mileage 2/2/09 3/26/09 23.65
Total 23.65
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.
362100 Schlemmer, Paula Allowed 20
9455 Canopy Lane
Fishers, IN 46038
In Sum of
23.65
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4343004 23.65 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
Signature
23.65 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund