HomeMy WebLinkAbout213931 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 365946 Page 1 of 1
ONE CIVIC SQUARE NANCY GOINS CHECK AMOUNT: $97.13
`. CARMEL, INDIANA 46032 C/O ESE
CHECK NUMBER: 213931
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 43 . 29 TRAVEL FEES & EXPENSE
1082 4343000 53 . 84 TRAVEL FEES & EXPENSE
1S ,
NUMUD 1T MM NOW OT ACOOMM ( Cams xmw Ao 101 Oat
MILEAGE CLAIM
MM�S ON ACCOUNT OF APPROPRIATION NO. FOR��
( cm
[6 FROM TO FADING AUTO tdR 8Jl Gx
P= POD1T START FEMMI NATURE OF aysnrRSR TRAVVRW) ® ME •
PER MILS
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f F It tl v
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L-22 Is (i�zl iAAt d
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AUTO LWJWSl NO. TOTALS S �+� i
+ SPEED0149M RMING oohmms axe to be need only when distnmoa between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 15Tloart* at the foregoing accouni 35 Just and correct,that the amount claimed is legally e, x allowWg all J ore
and tha/t�nr pant of th*5!me has been paid.
Data� (/ � ........,....._l gq
01' CT 16 2012
44 ONf
PRESCRIBED BY STATE BOARD OF ACCOUNTS GFSF.RAL FORM 110.101(1985)
p (� MILEAGE CLAIM K1 l ,n��l 6v
� 1 � 12.3 s `.k✓�-��'a ! �Ct�k�l(/�, CQ�' TO 1111 cal I ' lJV L
( ERNMENTAL UNI'[)
' 'v= � ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPAAThMff OR INSTITUTION)
ER
2 DATE FROM TO SPEEREADING DOMET+. AUTO MILEAGE
d NATUR OF BUSINESS MILES Q
�r POINT POINT START FINISH TRAVELED PER MILE
=9F 1
O' 12-
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.rt (�
•Y _ 3
3
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z
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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 c foregoing account is just and correct,that the amount claimed is leg due,after atiowin 1 Ius redlts
and that no art of he same has been paid
Date
,43 Zq
93� ��77,'7 ID
\U/ 1 �CT 16 2012
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.
365946 Goins, Nancy Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
10/10/12 Reimb Mileage 6/26 - 8/20/12 $ 53.84
10/10/12 Reimb Mileage 8/27 - 10/2/12 $ 43.29
Total $ 97.13
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.
365946 Goins, Nancy Allowed 20
In Sum of$
$ 97.13
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#fTITLE AMOUNT Board Members
Dept#
1082-1 Reimb 4343000 $ 53.84 1 hereby certify that the attached invoice(s), or
1081-1 Reimb 4343000 $ 43.29 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
18-Oct 2012
Signature
$ 97.13 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund