186231 06/09/2010 CITY OF CARMEL, INDIANA VENDOR; 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
4 CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK AMOUNT: $94.10
NOBLESVILLE IN 46060
a CHECK NUMBER: 186231
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMS 90.10 TRAVEL FEES EXPENSE
I
GENERAL FORx RO. Im (waW
PRESCRIBED BY STATE BOARD OF ACCOIJNTS
MILEAGE CLAIM
(GOVERNMENTAL uNln ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DEPARTMXKr OR INSTr=10N)
SPEHDOMETER AUTO MILEAGE
DATE FROM TO READING MILES Q
�a
POINT POINT START
FINIS NATURE OF BUSINESS TRAVELED PER MILE
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AUTO LICENSE NO. TOTALS i of
SPEEDOMETER READING columns are to be used Duly 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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no rt f f n" has been paid
;'—Date- {J L U
JUN 0 1 2010
v
PRtSCRIRLO BY STATE BOARD OF ACCOUNTS GENERAL FORK NO. ]CI UWS)
MILEAGE CLAIM C C J
tOOVERNMENTAL UNl'n
ON ACCOUNT T OF OF A PPROPRIATION NO- FOR
(OF. BOARD, DERARTFD7(7 OR INSTTTUTION)
SPEEDOMETER V
DATE 1l,EGE
FROM TO I READING t- NATURE OF BUSINESS
V POINT POINT START FINISH
PER MILE
3
1
3
MGM
l� C1 f
I
W On-k-- o
3.
d
AUTO LICENSE NO. TOTALS J 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 jusl and correct, that the amount claimed is legally due, after aliowinq all just credits
end tha4 rl part o the �sgme has been paid.
Dade L -i l I O\ I
q L s
p
JUN 0 7 2010
f e .................e.,.o
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.
360144 Canada, Cyndi Terms
11508 Lucky Dan Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/14/10 Reimb. Mileage 319 5114110 90.10
Total 90.10
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.
360144 Canada, Cyndi Allowed 20
11508 Lucky Dan Dr
Noblesville, IN 46060
In Sum of
90.10
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb. 4343000 90.10 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
3 -Jun 2010
Signature
90.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund