190335 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364750 Page 1 of 1
ONE CIVIC SQUARE JESSICA BALLINGER
CARMEL, INDIANA 46032 10830TOOLEY CT CHECK AMOUNT: $99.00
APT IF CHECK NUMBER: 190335
o
INDIANAPOLIS IN 46234
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 99.00 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE aOAPD Of ACCOUNTS
GENF.AALFOAEd NO. 101 09fifi7
MILEAGE CLAIM
To J essifva
IGOVERNMENTALUN1r
ON ACCOUNT OF APPROPRIATION NO- FOR
(oF.[CR, ROARD. DEP"nzv T oR 1NSrtruT10N)
FROM TO S PEEDOMETER
AUTO MILEAGE
2 DA I READING
(l NATURE OF BUSINESS MILES c
POINT POINT START FINISH TRAVELED PER MILE
V n e
`r 'P /L f4 I 1 SO
Ocil vi WC ftm mcc cp%
VtT c�
Z to C d
C
MCC U0
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0 0
1-51 WC a S
8 00
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1 W G MCC C 06
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WC
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5 WC I S s o MC vi 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 aliowing all just credits r
,end that no part of khe same has been paid.
Date
ra i rMa %177 U V r,
pt N LAI� SE 16 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.
Ballinger, Jessica Terms
Invoice Invoice Description
pate Number (or note attached invoice(s) or bill(s)) PO Amount
9115110 Reimb Mileage 7131 9115110 jj 99.Q0
Total 99.00
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.
Ballinger, Jessica Allowed 20
In Sum of
99.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -10 Reimb 4343000 99,00 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
23 -Sep 2010
Signature
99.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway.fund