HomeMy WebLinkAbout228461 1/28/2014 "F CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
CARMEL, INDIANA 46032 CHECK AMOUNT: $154.01
11508 LUCKY DAN DRIVE
a� NOBLESVILLE IN 46060 CHECK NUMBER: 228461
CHECK DATE: 1/28/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 154 . 01 TRAVEL FEES & EXPENSE
JAN 10 2014
MSCIUBED ST STATE BOARD OF ACCOUNTS GUMMIAL FOAM 110 101 11956]
MILEAGE CLAIM
TO
o6vr.RxAfRrAL—umn ON ACCOUNT OF APPROPRIATION NO. FOR
(OF10E,BOARD.DEFARM40(1 011 VISM7111109)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING + NATURE OF BUSINESS MILES &fYr%C:i �
POINT POINT START FINISH PER MILE
�-gn&v P1 ie
-�'i 4�—
ta— r-4,--41A�Cn a �4
�4 IL4
t 0 mc_c_
frlT —. -5 ,L4
W a--L fyN cc_ .-r—
mc_ t
I a I .2,n C C
7, 14
roc
Si
3 Ll
YY)C f -------
_Ile
A4L—
LA_0
�Wa—L. M-17 ry
VY'\C C— D2
YVA c-C
AUTO LICENSE NO. TOTALS ,1
13-11
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct.that the amount claimed is legally due,after ariowing all lust credits
end that no rart of to same has been paid.
Date
kv I �+/ rC
GENERAL FOAM NG 101 114667
PRESCRIBED BY STATE BOARD OF ACCOUNTS
MILEAGE CLAIM -1 _
(GOVERNMENTAL(DIITI (p�Q�'
ON ACCOUNTj,OF•APP,@OPRIATION NO.� � FOR
(OF,-ICE.BOARD.DEPARTWXXT OR INSTTFITT109)
SPEEDOMETER — AUTO MILEAGE
GATE FROM TO ---- --'-P'------•
1I READING + NATURE OF BUSINESS MILES dry c
za POINTPOINT START FINISH IRAVELEb PER MILE
C -
12 ( cf�� "1 C 1�
1' -. r A -
cr
--- - SH
m
-r' -
rVIII
T
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot he determined by fixed mileage or official highway map,
Pursuant to the provisions and penalties o1 Chapter 155,Acts 1353,I hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after aliowing all Iust credits r
end that no pa of tah-e� me has been paid
Date �i
JAN 10 2014
i
VU-5ZISAW D7$?Art HOAma Of ACCOUM HY: c:NrDA1 roma.0 1C:u"61
MILEAGE CLAIM -1
to
( fJIN16EN7A4lfN(11
ON ACCOUNT OF APPROPRIATION NO. FOR
v._._._.—_. (Druce.soAAn.r" ox tNsntvr(ONt
SPF1iU0?i61'Fll
�Dl� FROM _..— 70 READING + I AUTO ►U JAGF
-^-'-t— —• NATURE OFBUSINM bum a�r� t
FDINT POINT S:AAT fIh1SH 7RAVLLEU PER MILE
- --�--�-�----� -:mom ---- ---�--- - � � -
'tir �
cry - -- --
trM - i�(,JS - -
m _ _ sn s� -
So l �-_._. ..._ — --- - �e r x.16:
3 LA
Z lam' - - -
—+ - C-C_ -� ------
A21
-----C ---
` - -- -
_ ------- t `M C-- 3t
1P iTrmo 4-i n0I < - _
AUTO LICENSE NO. TOTALS
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determinod by fixed mileage or official highway map,
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby ceTtity that the fnrenoing account is jus]and correct.Thal the amount claimed Is Legally due,after a
end that no paft of the same has been paid.
Date 124 -) __..
� 3 3
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/30/13 Reimb Mileage 8/20 - 12/30/13 $ 154.01
Total $ 154.01
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
t Voucher No. Warrant No.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
4 . In Sum of$
$ 154.01
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1081-4 Reimb 4343000 $ 154.01 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
21-Jan 2014
Signature
$ 154.01 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund