243665 3 /31/2015 G
CITY OF CARMEL, INDIANA VENDOR: 364750
.ji ONE CIVIC SQUARE JESSICA BALLINGER CHECK AMOUNT: $"""`119.60`
�. ?a CARMEL, INDIANA 46032 10830 TOOLEY CT CHECK NUMBER: 243665
APT IF CHECK DATE: 03/31/15
INDIANAPOLIS IN 46234
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 119.60 TRAVEL FEES & EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.10)(LBBB)
MILEAGE CLAIM zSS i c� mer C4J-7&',
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
COMM,BOARD,DEPARTMENT OR INST.T.T MoN)
SPEEDOMETER
DA FROM TO READING + AUTO MILEAGE
VIS NATUREOF BUSINESS MILES p l a E
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.
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. t ��
Date t i 10,qS _...
3g3oo�
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.
364750 Ballinger, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/11/15 Reimb Mileage 1/5-2/18/15 $ 119.60
Total $ 119.60
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
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Voucher No. Warrant No. II
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364750 Ballinger, Jessica Allowed 20
In Sum of$
$ 119.60 '
ON ACCOUNT OF APPROPRIATION FOR f
108 -ESE
PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members
Dept# 4
1081-10 Reimb 4343000 $ 119.60 �I 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
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March 25, 2015
'P
I
Signature
$ 119.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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