187012 06/23/2010 e "yf CITY OF CARMEL, INDIANA VENDOR: 364274 Page 1 of 1
8 ONE CIVIC SQUARE ANITA RODIGUEZ CHECK AMOUNT: $28.00
ie' +Fa CARMEL, INDIANA 46032
CHECK NUMBER: 187012
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 28.00 TRAVEL FEES EXPENSE
PRESCR BY STATE HOARD OF ACCOUNTS
GINVIAL FOAy 1 +0. 401 I IVH67
MILEAGE CLAIM f
TO 1t��,r 64 1 cr..�r�
f� VERNMENTAL UNM
ON ACCOUNT OF APPROPRIATION NO. FOR
n0£, HOA Rn, pFPART?l2M OR INSTITUTION)
SPEEDOMETER
DAT FROM TO I READING AUT MILEAGE
2p POINT POINT START FINISH NATURE OF BUSINESS T—E I
PER MILE
iE�
w-7-1
Gr f S
1A e 2'
&7 LJ,' r
4 ui" 7e-c 112 ,J' e_ s
L- 6 r4l- 17 e 17 .ms s r
i
S
7 r .S /C L" rP rr- s r cb
I
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, I hereby certify that the foregoing account is just and correct, that the amount claimed isis leg after al' wing all juste its
end that n part of the same has been paid.
Date
v
JUN 0 4 2010
V 4. °5
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.
Rodriguez, Anita Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/27110 Reimb Mileage 1119 5127110 28.00
Total 28.00
I hereby certify that the attached invoice(s), or bills) 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.
Rodriguez, Anita Allowed 20
In Sum of
IS
28.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb 4343000 28.00 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
17 -Jun 2010
Z ��.�/Y/7/mD/`7
Signature
28.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund