189997 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 364715 Page 1 of 1
ONE CIVIC SQUARE DENEYSE SOLAZZO
0 CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 14151 PEPIN PLACE
CARMEL IN 46032 CHECK NUMBER: 189997
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 50.00 TRAVEL FEES EXPENSE
IN
PRESCRIBED BY STATE HOARD OF ACCOUNTS GENERAL -FORT1 IIG. 401 11906)
MILEAGE CLAIM
ro
160VrANMENTAL UNTn ON ACCOUNT OF APPROPRIATION NO. FOR
(OFr10E, BOARD, DEPARTMENT OR INSirr[7'r108)
SPEEDOMETER
AUTO MILEAGE
DATE
FROM TO I READING f MILES 54C� C
POINT NATURE OF BUSINESS TRAVELED
POINT START FINISH PER MILE
2 M M cc.
C- LC M x c r Y. c
Ir L c,
l L T rtkv 5chc i
L
1 Yp tN f-,r, 1v StJ4'u b t
y g jry Mfrc
-T Y t n -1-0 mot l
(ZWrn ie S'rltic
o WL
3 I
AUTO LICENSE NO. TOTALS `oo ry\ j4 60 O O
.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 1453, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits
end that no part J Q f t the same has been paid. t�]a.,,
Date I I 1 116 �lA�}JIII -'jj
(A
jiz; jen
11
/r 5EP 0 7 X010
]BY
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.
Solazzo, Deneyse Terms
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) PO Amount
50.00
911110 Reimb Mileage 8110 8/31110
Total 50.00
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
Voucher No. Warrant No.
Solazzo, Deneyse Allowed 20
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -9 Reimb 4343000 50.00 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
9 -Sep 2010
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund