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189933 09/14/2010
CITY OF CARMEL, INDIANA VENDOR: 363773 Page 1 of 1 ONE CIVIC SQUARE JOELLE OGLE CHECK AMOUNT: $79.75 CARMEL, INDIANA 46032 9203 CROSSING DR FISHERS IN 46037 CHECK NUMBER: 189933 CHECK DATE: 9/14/2010 DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION 1081 4343000 REIMB 34.00 TRAVEL FEES EXPENSE 1082 4343000 REIMB 45.75 TRAVEL FEES EXPENSE pFMCRIB£D BY STATE BOARD OF ACCOUNTS J GENERAL FORM HO. IN (19857 �z MILEAGE CLAIM V TO IGOVERNM£NTAL UNH7 ON ACCOUNT OF APPROPRIATION NO. FOR a o� o (OF ICE, BOARD, DEPARTMENT OR INSrT 1014) SPEEDOMETER AUTO MiLF1 DATE FROM TO READING +U r POINT POINT START NATURE OF BUSINESS MILES (t r FINISH TRAVELED PER MILE 11 KACQ C C kA S o c v s I NA 71 i T 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 is legally due, after aliowing all just credits and that no part of the same has been paid. Date p© fl S E P 0 7 2010 1 BY... ARCSCft18CP BY STATE BOARD Or ..CCOUNlS GE2tF.RlU.PORM HG. 101 (19867 I MILEAGE CLAIM i►Vlj V V U t TO Q VfRH7A U i v ON ACCOUNT OF APPROPRIATION ND. FOR (Ofi7CF, OA Hn;o AR OR IN IOH1 SPEEDOMETER DATE FROM TO I REAFJING NATURE OF BUSINESS TRAVELED t POINT POINT START FINISH TRAVELE<Z PER MILE LG SG iii V1 b t Z t 4 W Gtn t tM Z) Nh are, Z+ }z -i vvt-+ CC, i AUTO LICENSE NO. TOTALS y 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 is legally due, after aliowing all just credits end that no part of the same has been paid. Date r 7,7 S C"r 7 2010 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. 363773 Ogle, Joelle Terms invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO 34.00 Amount 8126/10 Reimb. Mileage 813 8126110 45.75 8126110 Reimb. Mileage 813 8126/10 Total 79.75 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. 363773 Ogle, Joelle Allowed 20 In Sum of 79.75 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -3 Reimb. 4343000 34.00 1 hereby certify that the attached invoice(s), or 1082 -2 Reimb. 4343000 45.75 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 79.75 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund