HomeMy WebLinkAbout174757 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 362745 Page 1 of 1
ONE CIVIC SQUARE KELSEY MILLER CHECK AMOUNT: $109.51
CARMEL, INDIANA 46032 13259 EASTWOOD LN
FISHERS IN 46030 CHECK NUMBER: 174757
CHECK DATE: 7!22(2009
DEPARTMEN ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 109.51 TRAVEL PER DIEMS
PRISCRIBCD BY STATE BOARD OF ACCOUNTS GENF.pA F Rid NG. IQ4 X14867
MILEAGE CLAI
ro V l
t�� C N J i trttnl
J ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, B DU OR TW871 FUr1011)
D�i',E7, FROM TO SREADIING *ER AUTO UULEAGE
2° POINT POINT START FINISH NATURE OF BUSINESb TRAV LED I S Gj
PER MILE
Y`I L.,
J v
i
t 1
i
IA
QA,:
i errl
"17 S o ti `i- o
i C... G
Q
4n lab L-0 CnAl CA4
I
1- c
r
1"10V)VV I F�— F
�•L
AUTO LICENSE NO. TOTALS r
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, bets 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no part of the same has been paid.
Dale
JUL 0 7 1009
FMCAIBED BY STATE BOARD OF ACCOUNTS GFXFAAL FOAM NC, 101 (I"$)
MILEAGE CLAIM
TO
9ANI9ENTAL UNM ON ACCOUNT OF APPROPRIATION NO. FOR
CB, BOARD. DEPAATT.47IT OR INSTRULIOX)
sPF�oor/ETER
FROM TO AUTO MIlSAGE
DATE READING i-
POINT POINT START FINISH NATURE OF BUSINESS TRAVE
PEA MILE
o G
C.
l
UYl
I
UY� c
i
o m
i VV
-Uz—
4
.1
T'T i
AUTO LICENSE NO.
TOTALS
$PEEDOMETEA READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
r
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, a fter aliowinq all just credits
and that no part of the same has been paid-
Date
(a
JUL 0 7
ID 9
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
362749 Miller, Kelsey (Blake) Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
713109 Reimb. Mileage 3118109 713109 109.51
Total 109.51
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
,20
Clerk- Treasurer
Voucher No. Warrant No.
362749 Miller, Kelsey (E3iaq) Allowed 20
In Sum of$
109.51
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ALCT #fTITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 109.51 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
16 -Jul 2009
Signature
109.51 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund