183692 03/25/2010 CITY OF CARMEL, INDIANA VENDOR: 363392 Page 1 of 1
ONE CIVIC SQUARE JAMES WHITELEY
4 CHECK AMOUNT: $21.50
CARMEL, INDIANA 46032 CHECK NUMBER: 183692
CHECK DATE: 3/25/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 21.50 TRAVEL FEES EXPENSE
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PREBCAIBCP By STATE BOARD OF ACCOUNTS GENERAL FORM NO- 181 11986) MILEAGE
CLAIM V 0.V-2C1
(OOVERNMrNrAL UNm
ON ACCOUNT OF APPROPRIATION NO. FOR
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(OFFICE, BOARD, PESAATa@!T OR Wrn"UrION)
SPEEDOMETER
DATE FROM To I READING AMIiES
F POINT POINT START FINISH NATURE OF BUSINES6 YRAVELED
PEA MILE
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AUTO LICENSE NO- xGZ S TOTALS �3
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 legally due, afte 'owing all just its
end that no part of the same has been paid.
Date
<71 3 V00
MAER 3 7 1010
�.r BY.
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, Jaynes Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
2/22110 Reimb. Mileage 211 2126110 21.50
Total 21.50
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
Voucher No. Warrant No.
363392 Whiteley, James Allowed 20
In Sum of
21.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members
Dept
1081 -4 Reimb. 4343000 21.50 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 -Mar 2010
Signature
21.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund