190339 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA KARSAS CHECK AMOUNT: $32.85
CARMEL, INDIANA 46032 15439 HARMON PLACE
NOBLESVILLE IN 46060 CHECK NUMBER: 190339
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 32.85 TRAVEL FEES EXPENSE
PRLSCRI9LD BY STATE BOARD OF ACCOUNTS GTNFAAL FORM 110. 101( 1986)
MILEAGE CLAIM
TO
460VERNMENTAL in rs
ON ACCOUNT OF APPROPRIATION NO- FOR
(OFFICE BOARD, DrpAxn -E: 1't OR 7NstmirIom
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE
POINT POINT START FINISH NATURE OF BUSINESS TRAVELER a
PER MILE
5 'Z5
S 2S ;p b Y 3, H
Of
4
C LC k; IL
h
W t
ni( r nAlL
11
i7
AUTO LICENSE NO. TOTALS as 3 g V
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 allowing all just credits
and that no part of the same has been paid. I�
Date 1 0
�e9 4E
St 16 2014
(0 f
L ....9
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.
Terms
361801 Karsas, Alyssa
InqDateNumber invoice Description
or note attached invoice(s) or bill(s)) PO Amount
9Reimb. Milleage 5125 8/17/10
32.$5
Total 32.85
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,
361801 Karsas, Alyssa Allowed 20
In Sum of
32.85
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -5 Reimb. 4343000 32.85 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
32.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund