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HomeMy WebLinkAbout179327 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 362749 'Page 1 of 1 ONE CIVIC SQUARE KELSEY MILLER CARMEL, INDIANA 46032 13259 EASTWOOD LN CHECK AMOUNT: $105.66 FISHERS IN 46038 CHECK NUMBER: 179327 CHECK DATE: 11/1112409 DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION .1046 4343004 105.66 TRAVEL PER DIEMS e` PRLSCRIBCD 87 STATL BOARD OF ACCOUNTS GENERAL FORM 110. 101 11986) L MILEAGE CLAIM P "C P GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (eff FIGE-BOARD, DEYKArKENT OA INSrMJrION) 6PEEDOMe['FA AUTO N DATE FROM TO RF.ADiNG f *NATURE OF BUSINESS MILES a POINT POINT START FINISH TRAVELED PER MILE IV o r o -10i'l 3 L i lI q L�_ ©1; O r G i 4 V`rr� tN I v1 d s'kn Y V--, rn 01'1 Cn tiL ,C L( a t^ t 1ri V o v\- O L 10 /;Jad T174 r AUTO LICENSE NO, TOTALS f 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, alter aliowing all just credits end that no part of the same has been paid. Date l' OCT 2 7 2009 t b.y PRESCRIBED BY STATE BOARD Or ACCOUNTS GENERAL FORM "O. ICI 119853 MILEAGE CLAIM cc TO "MENIAL "WITI ON ACCOUNT OF APPROPRIATION NO- FOR (OF, MA MD. Dry AR7W]W OR INSr[TUIlON) SPEEDOMETER .r DAJE E FROM TO l READING AUTO LIILEAGE V POINT POINT START FINiSii NATURE OF BUSINESS TRAVELED ED� PER MILE 9 L r O J V4 V zc W nV ri AUTO LICENSE NO. I V r T OTALS r 1 SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. /lY��la Pursuant to the provisions and penalties of Chapter 155, Acts 1553, I hereby certify that the foregoing account is just and correct, that the amount claimed is Ie ally due, after aliowing all just credits end that no part of the same has been paid. t Date ��yy ©OIJ05 2 7 2009 .....................n 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. 362749 Miller, Kelsey Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 10/21/09 Reimb. Mileage 716 10/21/09 105.66 Total 105.66 I 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. 362749 Miller, Kelsey Allowed 20 In Sum of 105.66 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. 4 ,CCT #/TITLE AMOUNT Board Members Dept 1046 Reimb. 4343004 105.66 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 5 -Nov 2009 Signature 105.66 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund