180931 12/30/2009 7 .171,1. CITY OF CARMEL, INDIANA VENDOR: 362099 Page 1 of 1
ONE CIVIC SQUARE KIM PREUSCH
i; 0 CHECK AMOUNT: $107.25
CARMEL, INDIANA 46032 1530 DEERFIELD DRIVE
t
PLAINFIELD IN 46168 CHECK NUMBER: 180931
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
'1046 4343004 107.25 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS ow \_.s GENERAL NO. 103 DIM) J MILEAGE C \Aon SJ Q�/�
(GOVERNMENTAL
SS ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT ON INSTITUTIONI
SPEEDOMETER
II AUTO MILEAGE DATE FROM TO READING F. 1 NATURE OF BUSINESS I MILES r D S
2.° 0 CI POINT POINT START FINISH 3 TRAVELED PER MILE
l A
—.AA 1
111.1111M
v l.c�_ I -;$.1" PA--c- 1
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ee A
NFL
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AUTO LICENSE NO- TOTALS G g I M d
,2} 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 i953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legally d e, after aliowi if a just credits
end that no pars of the same has been paid. J
Date 1l Y- A .1i4
1111
0 q (7 1 11-13 '41 5- 1 5? r
Li (s 1 :,E, DEC 1 0 2009
L_NEVVI
40-4 1 lir:
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.
362099 Preusch, Kim Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/4/09 Reimb. Mileage 10/29 12/4/09 107.25
Total 107.25
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.
362099 Preusch, Kim Allowed 20
In Sum of$
107.25
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
INVOICE NO. ACCT it/TITLE /TITLE AMOUNT
Dept
1046 Reimb. 4343004 107.25 I 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
23 -Dec 2009
)1d(WP/27,("
Signature
107.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund