HomeMy WebLinkAbout209806 06/18/2012 CITY OF CARMEL, INDIANA VENDOR: 365062 Page 1 of 1
ONE CIVIC SQUARE BASEL MAAROUF
CARMEL, INDIANA 46032 13239 MIDDLEWOOD LN CHECK AMOUNT: $12.15
FISHERS IN 46038 CHECK NUMBER: 209806
CHECK DATE: 6/1812012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 12.15 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD Or ACCOUNTS GENERAL FORM 110. 101 tlnb)
MILEAGE CLAIM g fr( %AP
(GOVERNMENTAL UNM Gl.
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPAATWXWT OB INSTTUTION)
SPEEDOMETER
DATE FROM To READING NATURE OF BUSINESS MIL O a 5 C
2� POINT POINT START FINISH TRAVELED /-PER MILE
4•_x_5
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 co r a amount claimed is legally due, after aliowing all just credits
and that no part of the same has been paid.1 T
Date K�
MqY
00� 30
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.
365062 Maarouf, Basel Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/8/12 Reimb Mileage 5/8 5/17/12 12.15
Total 12.15
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.
365062 Maarouf, Basel Allowed 20
In Sum of
12.15
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -7 Reimb 4343000 12.15 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
14 -Jun 2012
�rAw nmmv
Signature
12.15 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund