249960 09/23/15 °�CLAM
�% ti. CITY OF CARMEL, INDIANA VENDOR: 369016
® ONE CIVIC SQUARE NICOLE YOUNG CHECK AMOUNT: $"'.....94.28"
�.. =4 CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 249960
'a,,roN�� CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 94.28 TRAVEL FEES & EXPENSE
SEP -10 2015
PRESCRIBED By STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1985)
CMILEAGE CLAIM
TO
(GOVERNMENTAL UNIT]
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPAR7714ENT OR INSTITUTION)
---§PFIDOMETO
D FROM TO
READING + AUTO g�A-G
POINT NATURE OF BUSINESS MILES
POINT START FINISH TRAVELED
PER MILE
Co f
L-u 0Y K.
N— -Q1
E�3 , Ck r
V).n I i (A k TJK
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 of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct, that the amount claimed is le ally due,after aliowing all just credits
end that no part 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.
Young, Nicole Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
8/31/15 Reimb Mileage 7/9- 7/21/15 $ 94.28
Total $ 94.28
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.
Young, Nicole Allowed 20
In Sum of$
$ 94.28
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-3 Reimb 4343000 $ 94.28 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
September 17, 2015
Signature
$ 94.28 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund