HomeMy WebLinkAbout222576 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
1� ONE CIVIC SQUARE DENEYSE SOLAZZO CHECK AMOUNT: $319.84
v r CARMEL, INDIANA 46032 14151 PEPIN PLACE
L roN`o CARMEL IN 46032 CHECK NUMBER: 222576
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 226 . 11 TRAVEL FEES & EXPENSE
1082 4343000 93 . 73 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1W&)
MILEAGE CLAIM
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(GOVERN MENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(0 ,BOARD,DEPARTHEM OR MBTnU71ON)
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FROM TO SPEEDOMETER
READING } AUTO MILEAGE
F- POINT POINT START FINISH NATURE OF BUSINESS TRAVELED C4
PER MILE
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AUTO LICENSE NO. `-- TOTALS s
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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. v
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 du er allowing all just credits
Date
and that no part of the same has been paid.
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GEHERAL FORM NO.101(Mi)
MILEAGE CLAIM
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(GOVERKMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
tote ,HOARD,DEPARTMENT OR nismuItON)
DATE FROM TO SPEEDOMETER
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POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO. J TOTALS ^
+ SPEEDOMETER READING columns are to be used only whoa 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 ue, ter all Tving all just credits.
and that no part of the same has been paid.
Date
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENF-qAL FORM NO.161(L98E)
MILEAGE CLAIM N (,-Z26
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(GOVERKMENIAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD.DEPART14 M OR INSTnU710N)
D T FROM f0 SPEEDOMETER
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AUTO MILEAGE
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POINT POINT START FINISH TRAVELED PER MILE
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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. ✓ — IJ
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,DfteT allowing all just credits
and that no part of the same has been paid.
Date
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GVKMAL FORW 00 101 119?n
PRISCONED BY STATE BOARD OF ACC'<XIWM
MILEAGE CLAIM
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161OVEAWMERTAL UWni ON ACCOUNT OF APPROPRIATION NO.__ FOR
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zo POINT POINT START FINISH PER MILE
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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.
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Pursuant to(lie provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is juq1 and correct,that the amount cla� a�d Is legally due,after allowing rt credits.-
pnd that no part of.the same has been paid
Date
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.
Terms
364715 Solazzo, Deneyse
14151 Pepin PI
Carmel, IN 46032
Invoice Invoice Description PO# Amount
Date Number (or note attached invoice(s) or bill(s))
$ 226.11
7/15/13 Reimb Mileage 4/10 - 6/7/13 $ 93.73
7/15/13 Reimb Mileage 6/7 - 7/9/13
Total $ 319.84
1 hereby certify that the attached in 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$
$ 319.84
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-9 Reimb 4343000 $ 226.11 1 hereby certify that the attached invoice(s), or
1082-12 Reimb 4343000 $ 93.73 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
25-Jul 2013
Signature
$ 319.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund