HomeMy WebLinkAbout217063 02/13/2013 a \,f CITY OF CARMEL, INDIANA VENDOR: 366471 Page 1 of 1
ONE CIVIC SQUARE SHANDI BRAY
�. CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $273.50
*t.o„ CHECK NUMBER: 217063
CHECK DATE: 2/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 273 . 50 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO,10j(INS)
MILEAGE CLAIM
,o--54A�JDI t)QN
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO,_ FOR
(OF ICE,BOARD,DEPARTMENT OR INSMUTION)
FROM TO SPEEDOR—ET—a----7 AUTO
DATE
READING + NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED
PER MILE
cv.
S\J\-T 10 10
Dec 2 F< I nu) J—T 7�y�
Sig
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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. -4*22,621 &
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
FR C,E—Td_7
L JAN 1� I 2013
-J
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 140.10,(1986)
MILEAGE CLAIM
TO sawn Dl --t>Q�q
(GOVERNMENTAL UNIT) J
ON ACCOUNT OF APPROPRIATION NO.- FOR
[OFFICE,BOARD,DEPARTMINT OR INSTITUTION)
DATE FROM To SPEEDOMETER
READING + NATURE OF BUSINESS AUTO MILEAGE
MILES @
POINT POINT START FINISH TRAVELED
PER MILE
MCC
NIN W\c L/ I
r \N
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_—_--2Jo
NACC
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1-7
C
AUTO LICENSE NO, TOTALS qq
+ 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 1-1
JAN 21 2013
BY:---.,,--
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110.101(1986)
MILEAGE CLAIM
(GOVERNMENTAL MM
ON ACCOUNT OF APPROPRIATION NQ. FOR
(OFFICE,BOARD,DEPARTMENT OA INSTITUTION)
DATE FROM TO READ M +ER AUTO MILEAGE MILES @ 70�- POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
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N
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t CAN WDt��
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rl" -r L' C C ---- -nil
y
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AUTO LICENSE NO, TOTALS Z��� I S •`J
+ 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 credits
end that no part of the same has been paid.
Date � �l
,� (1 FREE 1 N 2 1R 2013 j
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.
366471 Bray, Shandi Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
1/11/13 Reimb Mileage 9/4/12 - 1/11/13 $ 273.50
Total $ 273.50
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.
366471 Bray, Shandi Allowed 20
In Sum of$
$ 273.50
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#[TITLE AMOUNT Board Members
Dept#
1081-3 Reimb 4343000 $ 273.50 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
7-Feb 2013
Signature
$
273.50' Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund