HomeMy WebLinkAbout223218 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 363382 Page 1 of 1
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ONE CIVIC SQUARE MEAGAN STORMS CHECK AMOUNT: $230.26
CARMEL, INDIANA 46032
�a CHECK NUMBER: 223218
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 150 . 95 TRAVEL FEES & EXPENSE
1082 4343000 79 . 31 TRAVEL FEES & EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNT G4ZIFAAL FORM NO.101(L"S)
MILEAGE CLAIM
TO-__ M004W
(GbVgKWFYTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO._ R
(OFFICE,BOARD, ARTMENT OR INSMUTION)
D FROM TO SPEEDOMETER TER I AUTO
ES
(V_ JJ NATURE OF 13USINESS MILES PORT START FINISH PER MILE
LED
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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. �J
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
and that no part of the same has been paid.
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PRESCRIBED BY STATE BOARD OF AOCOUN75 GFNEPAL FORM NO.IW(19P6)
MILEAGE CLAIM < [�
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ON ACCOUNT OF APPROPRIATION NO.
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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 certify that the foregoing account is Just and COTrect,that the amount claimed is legally due,after allowing all just credits.
end that no part of the same has been paid.
Data
i � AUG - 5Z013
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.IDI(1986)
MILEAGE CLAIM p
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(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPAA7MEtrr OA INSTITUTION)
DATE FROM TO I READ G {A
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AUTO LICENSE NO. TOTALS `'l J
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. "l
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
'1
�(]� AUG - 5 X913
PRESCRIBED H7 STATE HOARe Or ACCOUNTS
GENERAL MAW NO.101 119867
MILEAGE CLAIM
TO Ut f
(OOVEANNENTAL UNIT)
ON ACCOUNT OF APPAOP JON NO. FOR
(OF:ICE,HOARD,DEFAAT}IENT OR INSTIT'LMON)
SPEEDOMETER
DA FROM TO READING + AUTO
�-� POMT POINT START FINISH NATURE OF BUSINESS 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-
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 —el
AUG
1_
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
8/5/13 Reimb Mileage 4/10 - 5/20/13 $ 150.95
8/5/13 Reimb Mileage 5/27- 6/28/13 $ 79.31
Total $ 230.26
I 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$
$ 230.26
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-7 Reimb 4343000 $ 150.95 1 hereby certify that the attached invoice(s), or
1082-11 Reimb 4343000 $ 79.31 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
8-Aug 2013
Signature
$ 230.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund