181111 01/13/2010 /:',9 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
1• :,0 ONE CIVIC SQUARE HELEN BALLINGER CHECK AMOUNT: $26.79
CARMEL, INDIANA 46032 12913 CURRIER STREET
CARMEL IN 46032 CHECK NUMBER: 181111
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4343004 26.79 TRAVEL PER DIEMS
P11ESCIUEED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110. ,e1 (1861)
y 0,44 MILEAGE C r I
r i covFxNM 'TAL UNIT) ON ACCOUNT OF APPROPRIATION NO FOR
(OFFICE, BOARD, DEPARTMENT OR INSn1Ur1ON)
DATE FROM TO REAM M +ER AUTO MILEAGE
2-0 l p( r_________ NATURE OF BUSINESS MILES 55 c
POINT POINT START FINISH TRAVELED 1 PER MILE
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AUTO LICENSE NO. TOTALS f 6.90 a (p r f R
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount.clainied is legally due, after allowing all just credits
and that no part of the same has been paid. J
Date -w
g rict-c C t 4: 1 4 j I 1 f
f JAN 04 2010 11r l_i 0
'I li
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, IN 46032
Invoice Invoice Description
Date Number Amount
12/29/09 Reimb Mileage 9/23 12/29/09 26.79
Total 26.79
I hereby certify that the attached invoice(s), or bills) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk Treasurer
Voucher No. Warrant No.
359600 Ballinger, Helen Allowed 20
12913 Currier Street
Carmel, IN 46032
In Sum of$
26.79
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or Board Members
INVOICE NO. ACCT #ITITLE AMOUNT
Dept
1125 Reimb 4343004 26.79 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
7 -Jan 2010
Signature
26.79 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim pad motor vehicle highway fund