213173 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
ONE CIVIC SQUARE DENEYSE SOLAZZO
CARMEL, INDIANA 46032 14151 PEPIN PLACE CHECK AMOUNT: $230.89
CARMEL IN 46032 CHECK NUMBER: 213173
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 183 . 16 TRAVEL FEES & EXPENSE
1082 4343000 REIMB 47 . 73 TRAVEL FEES & EXPENSE
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+ 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 159,Acts 1893,I hereby certify that the foregoing account is Just and correct,that the amount claim all Just credits.•
end that no part of the same has been paid.
Date
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NG.10i(1986)
MILEAGE CLAIM
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION WO. FOR
SPEEDOMETER
AUTO MILEAGE
FROM To ----READING + MILES Cg
DAT NATURE OF?BUSINFSS TRAVELED PER MILE
v1_ POINT POINT START FINISH
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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 1953,1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due,after aliowing all just credits
and that no part of the same has been paid.
Date
7 9/6
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,
364715 Solazzo, Deneyse Terms
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/10/12 Reimb Mileage 7/12 -7/30/12 $ 47.73
9110/12 Reimb Mileage 7/31 -9/6/12 $ 183.16
Mileage 1/3-3/27/12
Total $ 230.89
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.
364715 Solazzo, Deneyse Allowed 20
14151 Pepin PI
Carmel, IN 46032
In Sum of$
$ 230.89
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-1 Reimb 4343000 $ 47.73 1 hereby certify that the attached invoice(s), or
1081-9 Reimb 4343000 $ 183.16 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-Sep 2012
Signature
$ 230.89 Accounts Payable Coordinator
Cost distribution ledger classification if Title
s
claim paid motor vehicle highway fund
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