HomeMy WebLinkAbout208576 05/08/2012 CITY OF CARMEL, INDIANA VENDOR: 00351133 Page 1 of 1
f ONE CIVIC SQUARE LUCI SNYDER CHECK AMOUNT: $153.13
CARMEL, INDIANA 46032
CHECK NUMBER: 208576
CHECK DATE: 5/8/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1401 4343002 42.13 EXPENSES
1401 4343002 111.00 MILEAGE
EXPENSES: TRIP TO BLOOMINGTON, IN IACT
Re: IACT Health Insurance Trust
Carol Schleif Luci Snyder
Fuel:
Lunch: 34.13
Car Wash: 8.00 Remove tar from road construction in Bloomington)
Total Spent: $81.01
lte+aib.d by 8ta1• Beard o: Accrnm u.
�m �t al Focm No. 101 Cl tat
MILEAGE CLAIM
GOV R MENTAL TO i 4 DR.
AL UNIT) k
ON ACCOUNT OF APPROPRIATION N0. FOR_
(OFFICE. BOARD. DEPARTMENT OR INSTITUTION)
DATE FROM TO I SPEEDOMETER I AUTO IL -f
READING+ 1 MILES
NATURE OF BUSINESS I TRAVELED PER MILE
PO INT POINT START FIN[SH
I
11 114
j
j
i
i
I
V
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 due. after allowing. all just creel
and that no part of the same has been paid.
Date
Clain No. Warrant No. I have examined the within claim and.hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is -duly authenticated as required
by .law.
That it is based upon statutory authority.
That it is apparentiy t correct
incorrect
On Account of Appropriation No 'tor this ursing Officer
G O Q
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BOYCE CO.. MUNCIE, IND. Oil]]
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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
S� ZR RK Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
j ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund