HomeMy WebLinkAbout207901 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 360926 Page 1 of 1
ONE CIVIC SQUARE SHAVONNE HOLTON
CARMEL, INDIANA 46032 3707 N MERIDIAN ST APT 3B CHECK AMOUNT: $74.92
INDIANAPOLIS IN 46208 CHECK NUMBER: 207901
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 74.92 TRAVEL FEES EXPENSE
GENERAL FORD 110. 101 )19651
PMCRIBCO BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OfF7CE, BOARD, OEPARTI[FXT OR 1NSTCrlTrION)
SPEEDOMETER AUTO �MIL�E
FROM TO READING MILES a DAT
NATURE OF BUSINESS TRAVELED
v L POINT POINT START FINiS PEA MILE
5
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MCC i
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ry)OC
4A: MC
u
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rl n Z
1 4 _Zz-
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c 5�
AU O LICENSE NO. TOTALS Z 5 v 1
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 account is just and correct, that the amount claim is le 11 due, a e alia ring all just credits
end that no art of the same has been paid.
Date
MAR 3 0 1012
B Y IF..
PRISMI R0 By arATE aOARO OF ACCOMM
COMM Foew NO. lm (12M
MILEAGE CLAIM
TO
AL UHM
ON ACCOUNT OF APPROPRIATION NO. FOR
(0►FSCE.60m DWASTOW on
D FROM TO SPMOMMIM
��j WMING AUTO MII BAGS
POINT POINT START FINISH NATURE OF BUSINESS Mu Es P ER t
IV t
TRAVELHD
j
S
n.
C S
AUTO LICENSS NO. TOTALS 2 5
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 lust and correct, that the amount claimed d e, afteY ailtlwiag all just credits.-
end that -no ad of th same has been paid.
Date 3 C Z
MAR 3n 2012
�G 1
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.
360926 Holton, Shavonne Terms
8001 Canary Ln Apt A Date Due
Indianapolis, IN 46260
ce voice P Description
Date ber (or note attached invoice(s) or bill(s)) PO Amount
29/12 b. Mileage 1/31 3/29/12 74.92
Total 74.92
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
i
Voucher No. Warrant No.
360926 Holton, Shavonne Allowed 20
8001 Canary Ln Apt A
Indianapolis, IN 46260
In Sum of
74.92
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -1 Reimb. 4343000 74.92 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 -Apr 2012
fL
Signature
74.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund