251181 11/04/15 CITY OF CARMEL, INDIANA VENDOR: 367837
CHECK AMOUNT: S 19.70*(9,
ONE CIVIC SQUARE MIKE MARTIN �*��kMM1CARMEL, INDIANA 46032 C/O PARKS CHECK NUMBER: 251181
CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 19.70 TRAVEL FEES & EXPENSE
t
Ill "CEIV
OCT 19 Z015
GENERAL iOBL 110.101 0986)
PRESCRIBED BY STATE BOARD Oi ACCOUNTS
BY: _ MILEAGE CLAIM '� S�
JP-cc ,Q r
, fro — i ro
1CiOVr11XNENTAL 11Xfr) ON ACCOUNT OF APPROPRIATION NO. FOR .
(OMCY.BOARD,DEEARTn](T OR INSTMMION)
SPEEDOMETER Amp E
�DATE FROM TO C_ READING .t- NATURE OF BUSIMS RA 'LED
f
-J-J- POINT POINT START FINISH 1' VPER MILE
V d+A)
a
i
w
i
I
I
I
I
D+ AUTO LICENSE NO. TOTALS �T
'y
O /.6-,10-
+
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 co ect,that the amount claimed is legally due,site alio allll ''uBt credits..
and that no part of the same has bee aid,
Date
i
l
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
10/12/15 Reimb Mileage 8/27- 9/30/15 $ 19.70
Total $ 19.70
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
120
Clerk-Treasurer
Voucher No. Warrant No.
367837 Martin, Michael Allowed 20
In Sum of$
$ 19.70
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#ITITLE AMOUNT Board Members
Dept#
1081-11 Reimb 4343000 $ 19.70 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 20, 2015
Signature
$ 19.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund