186410 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 364002 Page 1 of 1
ONE CIVIC SQUARE ASHLEY LIVINGSTON
CARMEL, INDIANA 46032 3404 WOODFRONT PLACE
CHECK AMOUNT: $103.50
INDIANAPOLIS IN 46222
CHECK NUMBER: 186410
CHECK DATE: 61912,010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 103.30 'TRAVEL FEES EXPENSE
f:
PRESCRIBED BY STATE BOARD Of ACCOUNTS CXRFAAL FOAM 110. ICI (1906)
MILEAGE CL
17� Y'l ice// j�Q
iOOVER MENTAL UN111
ON ACCOUNT OF APPROPRIATION NO. FOR
(Of7ICE. BOAAD, DEPARTW3Wr OR INST=10Nf
FROM TO I REAB NG AUTO MILEAGE
2oBA POINT POINT STAR7 FINISH NATURE OF BUSINESS TRAVELED d 7 �1
PER au
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AUTO LICENSE NO. TOTALS r)`J
SPEEDOMETER READING columns are to be used only whey 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
and that no part of the same has been paid.
lie
Date
JUN U 1 200
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.
364002 Livingston, Ashley Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5114110 Reimb Mileage 416 5/14/10 103.50
Total 103.50
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.
364002 Livingston, Ashley Allowed 20
in Sum of
103.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #FrITLE AMOUNT Board Members
Dept
1081 -2 Reimb 4343000 103.50 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
3 -Jun 2010
Signature
103.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund