186420 06/09/2010 a CITY OF CARMEL, INDIANA VENDOR: 00352856 Page 1 of 1
ONE CIVIC SQUARE MIKE MCBRIDE
CARMEL, INDIANA 46032 C/0 ENGINEERING CHECK AMOUNT: $196.11
C/0 ENGINEERING CHECK NUMBER: 186420
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 196.11 EXTERNAL TRAINING TRA
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Ylelcome to Dunkin' Donuts
Store #346526
10930 Pendleton Pike, Indianapolis
5/27/2010 8:39:31 AM
Drive -Thru
Order Number: 761116
Register:5 Tran Seq No: 261115
Cashier:Charlen M.
1 •Ht Cof LG OrigBlnd 1.79
1 Black
Sub. Total: $1.79
Tax:
Total.: 1.95
Discount Total:
Change $0.04
Cash $2.00
HEY MERID!
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Franchisee: Please use PLU #201
IUM PIA
BP am /pm 83099
1545 E 38th Street
Indianapolis
Indiana 46205
Tel 3179200850
Site Number 11901090
Qty Name Price Total
1 MYOPLEX CHC CRM 140Z 3.99 3.99
1 JCKLNK BFSTK10Z 1.59 1.59
SubTotal 5.58
Total 5.58
Coupon 1.00
Serial 56
DEBIT 4.58
VISA DEBIT $4.58
Payment from Primary Account
Acct /Card XXXXXXXXXXXX1090
Auth 353682
Ref: 82323033
Resp Code: 000
Stan: 05641461979
Trace 00014151
SITE ID: 8831901
MERCHANT COPY
Receipt 750364 ORIGINAL
3 Mouhamadou 05/26/2010 13:26
Thank you for choosing AMPM
Prescribed by State Board of Accounts General Form No. 101 (1955)
1 MILEAGE CLAIM 1
TO
(Governmental Unit)
V Vk On Account of Appropriation No. for
(Office ard, Department or Institution
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE Sa
20L_ Point Point Start Finish TRAVELED PER MILE
S 2 1 2 C r 21 lb SD
�c I I P so
Auto License No. TOTALS
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after 1
allowing all just credits, and that no part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and
hereby certify as follows:
IN FAVOR OF
That it is in proper form;
That it is duly authenticated as required
by law;
That it is based upon statutory authority;
That it is apparently correct
incorrect
On Account of Appropriation No. for
Disbursing Officer
Allowed 20 T
o
in the sum of o
cD
N
x M-�
FD M
0
M
()mod of Commission)
�L O
FILED
m
c 0 m
o
m
0 m
m
(Official] Title)
O
(Da
TRAVEL/EXPENSE
REIMBURSEMENTS
For: June 4, 2010
Mileage to Milea a Back Parking Other Total Miles Total
Date Meeting Description Start Finish Start Finish Cost Costs Other Description Miles x $.50 Expense
5/24/2010 Hamilton County Surveyor Annual Drainage 17571 17592 $0.00 $0.00 21 $10.50 $10.50
Report Meeting (Noblesvilel 4H Grounds)
5/2512010 Lunch Meeting wl Cary, NC Representatives 17639 17685
(Lucas Oil Field) $5.00 $0.00 46 $23.00 $28.00
5/26/2010 US31 -CSS Mtg. w/ Westfield (Rundell 17727 17771 $0.00 $4.58 Lunch On way to Mtg. 44 $22.00 $26.58
Ernstberger Offices, 429 E Vermont)
5/27/2010 MPO IRTC Meeting (IndyGo Offices W 18804 18851 $0.00 $1.96 Coffee Before Mtg. 47 $23.50 $25.46
Washington St.)
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$8.00 $0.00 $0.00 $O.00
Refund Total $90.54
Welcome to Indiana Licensing Page l of 1
Indiana.
IRS!
Online Licensing
3
Payment Receipt
This page serves as your receipt for this transaction. Your payment will appear on your credit
card statement as "STATE OF IN WWW INGOV". To maintain this page for your records, you
may print this page by clicking the "Print Receipt" button below.
What to do next?
Renewal
Check back on the MyLicense site in 24 48 hours to see if your expiration date was
extended.
If not, this may mean there is a problem with your renewal application and you will be
contacted.
If you answered "Yes" to any of the disciplinary questions, you must provide additional
information before your renewal can be processed. You may still work with your current
license for up to 90 days while your renewal is being reviewed by the board.
License Cards
9 The agency no longer mails license cards free of charge. Please log in to the MyLicense
site in 24 -48 hours and, after verifying your expiration date has been updated, select
the "Order License Card" option. You may order a license card with an expiration date or
choose the free license card you print from your computer.
Payment received thank you.
Licensee: Michael T. McBride
License Number: PE10201118
Authorization Code: 035778
Received Date: 5/25/2010 2:37:30 PM
Transaction ID: 6025700
Credit Card Number: XXXX XXXX
XXXX
Fee Amount: $100.00
Enhanced Fee: $2.50
Instant Fee: $3.07
Total Payment: $105.57
Print Receipt w
Renew Another License
Logout
https:// mylicense. in.gov /EGov /PaynientResult.aspx ?answer= processed &credit_card_ numb... 5/25/2010
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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
Mike McBride
Purchase Order No.
Engineering Department
Terms
Date Due
Invoice invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a n/a mileage $78.50
05/25!10 PE license renewal 105.57
05/25/10 parking; Lunch meeting Lucas Oil $5.00
05/27/10 am meeting coffee $1.96
05/26/10 lunch on way to meeting $4.58
Total $1195 61
I 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.
ALLOWED 20
—Milo n"Qf� ride IN SUM OF
Engineering Department
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a 2200 4343002 1, bill(s) is (are) true and correct and that the
2200 4343002 $105.57 materials or services itemized thereon for
2200 4343002 5.00 which charge is made were ordered and
2200 4343002 1.96 received except
2200 4343002 4.58
tQ \a 20
Signature
4\,k I.,K
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund