HomeMy WebLinkAbout208046 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
ONE CIVIC SQUARE DENEYSE SOLAZZO
CHECK AMOUNT: $261.97
CARMEL, INDIANA 46032 14151 PEPw PLACE
CARMEL IN 46032 CHECK NUMBER: 208046
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CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 261.97 TRAVEL FEES EXPENSE
FEESCA18Ea BY BUTE MAID OF ACCOUM 011am" FORM HO. 101 (ISM
MILEAGE CLAIM �Q ir1P t J►�R �0�0.12
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A' UNM ON ACCOUNT OF APPROPRIATION NO. FOR
NXID, DIP OR UUMMOM
SPEEDOMETER
DATE FROM TO RBADINQ AUTO MDSAGE
NATURE OF BUSINESS
POINT POINT START FINISH '�VELM
PER MILE
12 Fx CC
3 mcc
i 'C�► Ntt�
3 i cc C"
3 S "CM MLC-
3
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3 Mcc
3 Z3 LL
3 Z b IK tk (r C
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3 1 z Mt_G Tf"1 \0 (v%.
AUTO LICENSE NO. TOTALS J I Z
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. TOTAL= 2 I
Pursuant to the provisions and penalties of Chapter 155, Acts 1853, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all lust credits
end that no part of the same has been paid.
Date n
1 MA R 2 8 2011
BY........................
PIRISCRIM BY SYATr BOARD OF ACCOUNTS GF.KFAAL FORT) IJG 101 TINS]
MILEAGE CLAIM
TO---- bbr\QA�. SNk6,11 0
i5ovERNmENTAL URM ON ACCOUNT OF APPROPRIATION No. FOR
(omcg. BOARD. DEPARTm3mr 5 nistYnniog)
SPEEDOMETER
DATE FROM TO AUTO MJLEAG�
I ----T-- NATURE OF BUSINESS MILES 55. 5 1
I POINT POINT START FINISH TRAVELED PER MILE
tA U-
Z
2- 14 fAcc
7 1 5 :�Cm
Z- MILL T M
2 TM
1 TM
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2 Z1 MU 6
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oi
MLC
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AUTO LICENSE NO. TOTALS i q I
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, 1 hereby certify that the foregoing account is just and correct that the amount claimed is legally due, aiteY a ru ing all lust credits.
end that no part of the same has been paid
Date
J
2012
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORW 110. 101 (INN
MILEAGE CLAIM
TO �Q1nP ASQ StIyKL W
(GOVERNMENTAL UNITt
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTUEKT OR INSTITUTION)
DATE FROM TO I S READNG AUTO M�jIL�jEA,G�jE
)-a NATURE OF BUSINESS TRAVELED 5
PONT PONT START FINISH PER MILE
l TM VA
M C C
1 CC.
1 MCA TP�1
I to tA X4'1
MCC T
1 10 MCL TM
1 LL TtA
Mr-C,TM
MU 'C M
i Clv
MCC C
1-I MQ T M
t A C TM
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mu-
LL TVA
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d�t TtA
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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 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 du fter aliowing all just cre its
and that no part of the same has been paid.
Date
L6QWa9V
t
MAR 2 8 2012
B Y
0) hah,
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.
Terms
364715 Solazzo, Deneyse
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
3/27/12 Reimb Mileage 1/3 3/27/12
261.97
Total i$ 261.97
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.
364715 Solazzo, Deneyse Allowed 20
14151 Pepin PI
Carmel, IN 46032
In Sum of
261.97
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -9 Reimb 4343000 261.97 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
Signature
261.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund