181436 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 363392 Page 1 of 1
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ONE CIVIC SQUARE JAMES WHITELEY CHECK AMOUNT: $21.23
i CARMEL, INDIANA 46032
pr CHECK NUMBER: 181436
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 21.23 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOR11 No. IN 41486)
MILEAGE CLAIM
T� CaV S 1�� 2 y
IGOVEANM DUAL UNIT)
r ON ACCOUNT OF APPROPRIATION NO- FOR
IOFICE, LARD DEPART1. Nr OR INSTITUnON)
SPEEDOMETER O 4 0
zODT FROM TO I READING
NATURE OF BUSINESS AUT
MILES 1 E
POINT POINT IMME FINISH TRAVELED
PER MILE
I 3 ►E. A C 1111i��
r f V
NM Milii r
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c ✓'''L e MIME -1 i MIME
111111111111MMIIIIIIIIIIIIIIIIMIIIIIII= M.... ME
I Mira
Mil IMMII
111.111= MEM
I= OEM
MEM 1 MIMI
AUTO LICENSE NO. 0 Or CZ• TOTALS 1 S15, 4 g, 2-
7 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 legs e, er aliowing'all pis edits r
end that no part of theme same
has been paid r 1
Date it 6/e 1 i I�, l ley ��`1U� e
t 1 DEC 2 1 2009 u'
,•,'T.
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.
363392 Whiteley, James Terms
1
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/18/09 Reimb. Mileage 12/1 12/18/09 1 21.23
Total 21.23
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.
363392 Whiteley, James 1 Allowed 20
,4 di
In Sum of
21.23
ON ACCOUNT OF APPROPRIATION FOR
rogram Fund
/0,/
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
Reimb. 4343004 21.23 I hereby certify that the attached invoice(s), or
/6F/- 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
/lkM is
Signature
21.23 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund