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189804 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1 ONE CIVIC SQUARE PAMELA GRIFFITHS CHECK AMOUNT: $72.00 CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE CARMEL IN 46033 CHECK NUMBER: 189804 CHECK DATE: 9/14/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1202 4343002 72.00 EXTERNAL TRAINING TRA Prescribed by Stale Board of Accounts MILEAGE CLAIM General Form No. 101 (1955) S AD m I TO p4 674i 5 DR. (Governmental nit) On Account of Appropriation No. for (Office, Board, Department or Institution DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE d Point Point Start Finish TRAVELED PER MILE 5 D E C r i na L t. 5r: 4, 14 5 ,ff9 C-UIIJ67 0610 EMA o�) PC G C 1 IJ W tel: 1 0 AG III W S E� nvi 6Z Q A C86LL E 7 0 C1 LL 25 q I I 0 I D a e_ ekll L "A i- C A LL, CCC r C r AV I~ r is C AL LT T a I- ALL zl .b b" V;C i u C- GG �'r IN GG S i� `t cc o 0 VV QuE E NA L f a C.f RA L L 5 dH I I !�f 6 11 c of r<e b. C L. I` I 3 a o 1 O' C+v,C C XXC 3 6T N W 402 aACII wi dA Z- aZ ID I C r4r= CIi/i _.Cf eI C, [L I r c L Pi t- 1 Pie-14 4 a( a !C- 5 Gi L Q V 1 c— 5 c? Gi-f e- I I I C f L L 1JL aLz t/1 'a I j c` C'd`VIG laelgl -G C C.� I l r i u o C- I! v✓ 3 °w t o 1/i h C144 Z I o InNE G V- c r~ -C rSYL r !?ti r i A V i 0 V 1 c_ cL 1 i✓ l I W, e C✓ V') 141C -6 C r.L r' T 5 f a' 07,fa WO L G L' Iff C i V, a L4 aa v r +a c 5 Auto License No. TOTALS 'SPEEDOMETER READING columns are to be used only when distance between points cannot be determin Id by fixed mileage or official highway map. Q 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 U SEP 13 2010 allowing all just credits, and that no part of the same has been paid. gY Date Claim No. WcurcLnt No. I have exctnnined 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 o -0 0�. Allowed ,20 (D o in the sum of O o (D 10(D� (Bond of commission) I 0 FILED Q m n o O p Q N E i En (Official Title) Prescribed by State Board of Accounts General Form No. 101 (1955) TO r 1 L DR. (Governmental Unit) SEP 1 9 Z 7�n J 3 On Account of Appropriation No. for (Office, Board, Department or Institution DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE 24 Point Point Start Finish TRAVELED PER MILE y ONE G 62WVE ('v- o i A b g f r, 6) u c -G i g Lx Z -C tWid, 0o1 co ue -Z- o o 6 1 CQ L L E e, ca f' u +V Gt vtX, iz 61 5 Pi2' r- e 1ar1 f 1�&-t fQi Le e i C r b UVi G oi- l fliT c4 1 01/ 0 1,411 t L 3 a✓ t- tlr a 62 u t h f a U 'i i C ILIJ J 17. l b V G G' J i) v C u vi 3 C lO C -4 HA LJL C ;261 Io `C C 1 t LL D J O 95 C.' V! I- 4Al C !it Lrrv) U EG'1 f 10 i i f oN' r- V J C C.a 1,L f i b o L 1 5,0LA1412Z Flr c 1 5t E— J 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 .allowing all just credits, and that no part of the same has been paid. ,Date i' y ��l 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 n cD Allowed 20 (D o in the sum of o TAT CD In (D ID (Board or Commission) I H FILED cD ca�o o a¢ m Cn m 9 (OAmcd Tifle) in VOUCHER NO. WARRANT NO. ALLOWED 20 Parr; Griffiths IN SUM OF $72.00 ON ACCOUNT OF APPROPRIATION FOR Carmel IS Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1202 1 060910 0701101 43- 430.02 1 $41.00 1 hereby certify that the attached invoice(s), or T 1202 1 050710 0607101 43- 430.02 1 $31.00 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 Monday, September 13, 2010 Director, IS Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/08/10 060910 070110 $41.00 09/08/10 1 050710 060710 I I $31.00 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IG 5- 11- 10 -1.6 1 20 Clerk- Treasurer