249667 09/23/15 �r CggMf
CITY OF CARMEL, INDIANA VENDOR: 368092
® 2I ONE CIVIC SQUARE TORRE DURRETT CHECK AMOUNT: $ " ....1 158.13-
CARMEL,CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 249667
�+..��ON��O` CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 158.13 TRAVEL FEES & EXPENSE
BFAU 2015
PROSCRIBED BY STATE BOARD OF ACCOUNTS U's j GENFAAL FORM 110.101 0"M
MILEAGE=C—LAIM:=- �� �`��
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To
ri ON ACCOUNT OF AFPROPRIATION NO. FOR
(OFFICE,BOARD"DEPARTMENT OR INS TTUTION)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE
�- READING i �® 1/
NATURE OF BUSINESSMILES -^�LLE�� C
POINT POINT START FINISH TRAVELED PER MI
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1 -7 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 claim is le y due,after al'o ut credits
end that ng pa of a sa5has been paid. 1
Date - L
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vI
1
.lC 4 Y�`
AUG 2 A 2015
PRESCRIBED Br STATE BOARD Of ACCOUNTS GENERAL FORE NC.101(1986)
' MILEAGE CLAIM L 8-�� Y""'"-�''�----"--_.J
TO(GOVERNIIENrAL uN ON ACCOUNT OF APPROPRIATION NO. FOR
(OfnCE,BOARD,DEFART)D]fr OR INSLITI TION)
r----"SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING t MILES �Z
NATURE OF BUSINESS TRAVELED � Lj
c
'LO- POINT POINT START FINISH PER MILE
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AUTO LICENSE NO. TOTALS I Cis
+ SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. �"Call7�
Pursuant to the provisions and penalties o1 Chapter 155,Acts 1953,I hereby certify that the foregoing account is jusl and correct,that theau claimed is gall due iter alio re�iT
and that n�}`palrt 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.
368092 Durrett, Torre Terms
6066 South Bay Dr
Indianapolis, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/24/15 Reimb Mileage 6/19- 8/26/15 $ 158.13
Total $ 158.13
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
i
Voucher No. Warrant No.
368092 Durrett, Torre Allowed 20
6066 South Bay Dr
Indianapolis, IN 46250
In Sum of$
$ 158.13
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-3 Reimb 4343000 $ 158.13 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
CCCU.
U;k— September 17, 2015
0
Signature
$ 158.13 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund