184721 04/27/2010 9
'Ca CITY OF CARMEL, INDIANA VENDOR: 360417 Page 1 of 1
ONE CIVIC SQUARE JESSICA DAVIS CHECK AMOUNT: $55.50
CARMEL, INDIANA 46032
CHECK NUMBER: 184721
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 55.50 TRAVEL FEES EXPENSE
e
PALSCA4HED HY 57AT£ BOARD Oi ACCOUNTS GENKHAL FORK No. 101 (1986)
MILEAGE CLA O TRAveL PEiZ DIEfv�
ro tt J�
(1VER111TAL IFNITt ���1
ON ACCOUNT OF APPROPRIATION NO. FOR `J
(OF 4CE. HOARD, DEPAATUQ2(T OF1 1NSrCrUTJOs)
SPEEDOMETER
I AUTO
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
DATE FROM TO READING C
PER
r
AUTO LICENSE NO_ TOTALS
UV
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 cart6 that the foregoing account is just and correct, that the amount claimed is legallj\due, after allowing all juifE c dits
and that a� of t e sa e has been paid. t
Date I I I l
J
APP J 4- 2010
BY:.......................
GENERALFORM NO ICI 09867
RACHC RIHCD HY STATL HOARD OT ACCOUNTS
MILEAGE CLAIM
To _TRAVEL PE2
XCF11f b L�C�iDhl 1% V 7
ic3o1- 10411TAL U1131 ON ACCOUNT OF APPROPRIATION NO- FOR
(OrJICC, OARD, DEPARTLUXt OR IWSTi Iox)
SPEEDOMETER AUTO
FROM TO I READING c
DATE POINT POINT START FINISH NATURE OF BUSINESS TRAVELS,
i
n
AU? LICENSE NO. TOTALS V
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, after aliowing all just credits
end that no pa of the same has been paid.
Date
D RW3
APIR 4 2010 l
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.
360417 Davis, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4114110 Reimb. Mileage 211 3131110 55.50
Total 55.50
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.
360417 Davis, Jessica Allowed 20
In Sum of
55.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. A.CCT #fTITLE AMOUNT Board Members
Dept
1081 -11 Reimb. 4343000 55.50 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
22 -Apr 2010
Signature
55.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund