303900 10/10/16 CITY OF CARMEL, INDIANA VENDOR: 363065
CHECK AMOUNT: $""'"'""398.74'
�= 6 '�l• ONE CIVIC SQUARE JAMES DOWELL
s ,?a CARMEL, INDIANA 46032 C/O PARKS-ESE CHECK NUMBER: 303900
CHECK DATE: 10/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 092216 206.28 TRAVEL FEES & EXPENSE
1082 4343000 092216 192.46 TRAVEL FEES & EXPENSE
Voucher No. Warrant No.
______
303065 Dowell, James Allowed 20____
83b3Barcroft Dr,Apt
Indianapolis, IN 48240
In Sum of
ONACCOUNT OFAPPROPRIATION FOR
108-ESE
rO#mINVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
/082-/3 Reimb. 4343000 $ 192.46 | hereby certify that the attached invnioa(s). or
1081-3 Reimb. 4343000 $ 206.28 biU(e) io (aro)true and correct and that the
materials orservices itemized thereon for
which charge ismade were ordered and
received except
October 4, 2016
Signature
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
9/22/16 Reimb. Mileage 5/19 - 7/11/16 $ 192.46
9/22/16 Reimb. Mileage 7/12 - 8/31/16 $ 206.28
Mileage 1/4-2/5/16
Total $ 398.74
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
-,�.CEJVIEID
Sr? 2.9 2016
i
Rv:_
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO.101(1996)
�-.
MILEAGE CLAIMTO— � Ap1S, xn `t6 2r '
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,BOARD,DEPARTMENT OR INSnTUTION)
DATE FROM TO SPEEDOMETER
READING + AUTO MII
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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 legall e,aft alIozving all just cret dips:'-
and thatrt of t e same has been paid.
Date �'.
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