250152 10/07/15 is fir.Cggyf
CITY OF CARMEL, INDIANA VENDOR: 360144
® ONE CIVIC SQUARE CYNTHIA CANADA CHECK AMOUNT: $ ....`210.61'
?� CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK NUMBER: 250152
NOBLESVILLE IN 46060 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343000 210.61 TRAVEL FEES & EXPENSE
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Vp"Cvn8T"IT STATI ROAR"Or Ar ro"TS ;'-;,t' `
MILEAGE CLAIM
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ON ACCOUNT OF APPROPRIATION NO. FOR �—
V[ARM[MtAL 1"181
IO,—.DOARD,DVARTftrrfI OB MS DN) ` AUTOmum
t1R•EAGE
� PEEDOMETl7t t
FROM TO READING + NATURE OF BUSINESS
'FSIAVELED PER MILE
POINT START FINISH _-
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AUTO LICENSE NO. _.
when distance between points cannot be determined by lined mileage or oIii.W highway map. a 1 v ,� AA
+ SPEEDOMETER READING columns are to be used oaly
Pursuant to Ute provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct.that the amoun►claimed is legally due,alter alio 4 a43•
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end that n pari of the same has been paid. n n —
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PRtSCRItlrD BY STATr BOARD OF ACCOUNTS \; GrIIFAAI TORY NC.101 IIYBFJ
MILEAGE CLAIM
TO
(OOVE"MENrAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
COMM,BOARD,Dr7AR'TICEKr OR INSTInalOM)
�DAT FROM TO SPEEDOMETER READING AUTO MILEAGE
POINT POINT START FINISH NATURE OF BUSIN£56 MILES M
PER NILE
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AUTO LICENSE NO. tc?TD'S a
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 o1 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
end that no,part o the same has been paid.
Date
"0�
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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
8/19/15 Reimb Mileage 6/16 - 8/4/15 $ 210.61 .
Total $ 210.61
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of$
$ 210.61
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
i Dept#
1082-14 Reimb 4343000 $ 210.61 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
October 6, 2015
Signature
$ 210.61 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund