HomeMy WebLinkAbout212782 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
ONE CIVIC SQUARE MEAGAN STORMS CHECK AMOUNT: $172.71
CARMEL, INDIANA 46032
CHECK NUMBER: 212782
CHECK DATE: 9/1212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 172 . 71 TRAVEL FEES & EXPENSE
PRLSCRIEED BY STATr BOARD OF ACCOUNTS GENERAL FOR.110.101 11906)
MILEAGE CLAIM
TO l
(GOVERNMENTAL UNIn
ON ACCOUNT OF APPROPRIATION NO. FOR
tOFi1Cr,BOARD,DE7ARTMENi ON INST(rVI108)
E FROM TO SPEEDOMETER AUTO MILEAGE
DA
7I READING + NATURE OF BUSINESS MILES a <
20 t POINT POINT START FINISH TRAVELED PER MILS
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ivrn
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L._._ S e
AUTO LICENSE NO. TOTALS
1 �
+ 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 tlfe aFnaunt claimed is legally due,after a o g all just credits
and that no part of the same has been paid.
Date n
" J l
\ SEP 05 2012
1
PRESCRIBED 157 STATE BOARD Or ACCOUNTS GENERAL FORM VC 101(1906)
MILEAGE CLAIM n G
To
(GOVERNMENTAL UN111
ON ACCOUNT OF APPROPRIATION N FOR
(OFi10E,BOARD.DErART1QlfT OR(NsTINnoN)
SPEEDOMETER
DATE FROM TO 1 READING + NATURE OF BUSINESS MILS 6 5s5 r
POINT POINT START FINISH TRAVELED PER MILE
YVNO
-- — I b- t
AUTO LICENSE NO. TOTALS Z��'2 15
Ll
+ 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 allow just credits
and that no part of the same has been paid. � �/�/�
Date
SEP 0 5 2012 ���"\
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"I-S=SED 13Y STAz BOARD°ACCOUNTS
GENKRAL TOW VC.101(INS)
/ CLAIM_—TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPUION NO. FOR
-FES
T PEUR)MILE
DATE FROM TO READING +
POINT POINT START FINISH NATURE OF BUSINESS
0.
AUTO LICENSE NO. TOTALS
+ SysDDOMDzDn READING columns are to be used only when distance between points cannot be determined b°fixed mileage n,official highway map.
Pursuant*the provisions and penalties v/Chapter zoy.Acts/oss.1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after allow' g all just credits
,ua ,^* o" pail of the same has been paid.
Date
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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.
363382 Storms, Meagan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/31/12 Reimb Mileage 7/2 - 8/31/12 $ 172.71
Total $ 172.71
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.
363382 Storms, Meagan Allowed 20
In Sum of$
$ 172.71
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-7 Reimb 4343000 $ 172.71 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
6-Sep 2012
. J e
Signature
$ 172.71 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund