249088 08/26/15 CITY OF CARMEL, INDIANA VENDOR: 366490 Page 1 of 1
1 � ONE CIVIC SQUARE MICHAEL MARTIN CHECK AMOUNT: $33.64
CARMEL, INDIANA 46032 1807 MILFORD STREET
o� CARMEL,IN 46032 CHECK NUMBER: 249088
CHECK DATE: 8/26/2015
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 33 . 64
,a
' GENERAL i0A 110.101 IIRBf)
PRESCRIBED BY STATE BOARD OF ACCOUNTS -
MILEAGE CLAIM lr�l C �� CSV "0001 )
ro /v C
C ) FAN TAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
o
IOfi1CY,BOAPD,DEPAATIONT OR IN'-rRUIlON) ,
SPEEDOMETER AUTO
FROM TO READING + MILES a W
� Is
POINT POINT START HDppg _ NATURE OF BUSINESS TRAVELED _
FINISPER MILE
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1 t 3 r r ----
rte 1
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y .
-.30
7�Po-f A4 CIA)O -- --
r le ar ; t Tv
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TOTALS r
AUTO LICENSE NO.
+ 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 a win all just credits.
and that no part of the same has been paid. \`
Date
AUGr19 2015 11
BY-
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.
367837 Martin, Michael Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/4/15 Reimb Mileage 4/23- 8/3/15 $ 33.64
Total $ 33.64
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.
367837 Martin, Michael Allowed 20
In Sum of$
$ 33.64
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-11 Reimb 4343000 $ 33.64 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
August 20, 2015
1P
Signature
$ 33.64 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund