186264 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 359554 Page 1 of 1
ONE CIVIC SQUARE CRYSTAL ETHRIDGE
CHECK AMOUNT: $136.00
CARMEL, INDIANA 46032 8621 CANTON COURT
INDIANAPOLIS IN 46234 CHECK NUMBER: 186264
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 136.00 TRAVEL FEES EXPENSE
r
PRrSCRIAED BY STATE BOARD OF ACCOUNTS GEMAL FOA61 NO. 181 119863
r y MILEAGE CLAIM
ESE TO
(GOVERNMENTAL UN
ON ACCOUNT OF APPROPRIATION NO. FOR
LOMCE, BOARD, DEPARTMENT OR INSTInUION)
DATE READING
FRdM TO SPEEDOMETER AUTC MILLS j r NATURE OF BUSINESS MII E3 S_., r
�Q POINT POINT START Ff...Sli 1'RAVt:LE6
PER MILE
(/a• C- m L) r
3.91 0. C-
LD C
3
C
41, Ito
I
3
WC,
Y E
E
S i!
5. V
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot he 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 aU juet credits
and that no part of the same has been paid.
L
Date
t
1�
JUN 1 2010
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.
359554 Ethridge, Crystal Terms
8821 Ganton Ct
Indianapolis, IN 46234
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5117110 Reimb. Mileage 3123 5117110 136.00
Total 136.00
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
f
Voucher No. Warrant No.
359554 Ethridge, Crystal Allowed 20
8821 Ganton Ct
Indianapolis, IN 46234
In Sum of
136.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. A.CCT #rrITLE AMOUNT Board Members
Dept
1081 -10 Reimb. 4343000 136.00 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
136.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund