303210 09/22/16 �' CITY OF CARMEL, INDIANA VENDOR: 363065
j �b ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $*******286.69*
,aQ: CARMEL, INDIANA 46032 C/O PARKS-ESE CHECK NUMBER: 303210
M„roN�a• CHECK DATE: 09/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 090516 286.69 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
363065 Dowell, James Allowed 20
9353 Barcroft Dr,Apt A
Indianapolis, IN 46240
In Sum of$
$ 286.69
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-3 Reimb. 4343000 $ 286.69 1 hereby certify that the attached invoice(s), or
0g0.51(Q 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 14, 2016
Signature
$ 286.69 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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.
363065 Dowell, James Terms
9353 Barcroft Dr, Apt A
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/5/16 Reimb. Mileage 2/29- 5/18/16 $ 286.69
Mileage 1/4-2/5/16
Total $ 286.69
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
n fy) a n Is .�I 4/6 20 z;- :►
SEP 092016
BY:
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORMINO.101(3086)
MILEAGE CLAIM a Mc S 16o
(GOVEBlDLENTA......) '
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING + AUTO
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'n NATURE OF BUSINESS
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+ 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 1 y due,after i' g all just credits.-
and
redits.and that no part of/the same has been paid.
Date ���
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SEP 092016 i
PRFSCRISED BY STATE BOARD OF ACCOUNTS GENFMA'L FORM NO.101(1880
! MILEAGE CLAIM J
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(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR INSUTUTION)
DATE FROM TO SPEEDOMETER READING AUTO MILEAGE
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PER MILE
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+ 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 legal e,after allowing all just credits
and that no part of.the same has been paid.
Date- 2-S- 14,
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