182968 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN CHECK AMOUNT: $34.60
ro CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
off INDIANAPOLIS IN 46208 CHECK NUMBER: 182968
CHECK DATE: 3!312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 34.60 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENFRAL FORM Ito- ICI (IR860
r MILEAGE CLAIM
TRAv PEe PIE 4
ICiOV1211."TAL UN71'1
ON ACCOUNT OF APPROPRIATION NQ. FOR
IOFrICE, BOARD, DrPAR'TWZNT Olt INSrMJTION)
SPEEDOMETER
DATE FROM TO I READING NATURE OF BUSINESS AUTO 1�'LP�
Z W- POINT TRAVELED START FINISH TRAVEL D
PER MILE
_�(DA 3
JMM N Re AG' -_L
q 'r M u SE
4l 1A 3
10 M
3 6
hfZ t e<i Ce r
paiUAttz ?fj Mo C
2f, N1oJT ti c 1 c�[n S
t
AUTO LICENSE NO. TOTALS
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 cl imed s all due, of iowing all just credits
and that part of the same he been paid.
Date
�oFJ0
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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1129/10 Reimb. Mileage 116 1/20/10 34.60
Total 34.60
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
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
34.60
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
'r
PO# or INVOICE NO. ACCT #rrITLE AMOUNT Board Members
Dept
1081 -11 reimb. 4343000 34.60 1 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
25 -Feb 2010
Signature
34.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund