159200 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 00350221 Page 1 of 1
ONE CIVIC SQUARE LINDA ACOSTA
CHECK AMOUNT: $23.23
CARMEL, INDIANA 46032 GO PARKS
CHECK NUMBER: 159200
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM DESCRIPTION
1046 4343000 23.23 TRAVEL FEES EXPENSE
i
I
I
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1886)
MILEAGE CLAIM
TO
(GOVERWENTA,UNIT) APR ON ACCOUNT OF APPROPRIATION NO, FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING t AUTO TEA E
19 NATURE OF BUSINESS MILES 0
POINT POINT START FINISH TRAVELED PER MILE
0— sti 2
M^
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, fter allowing• all just credits,
.end that no part of the same has been paid.
Date
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.
Linda Acosta
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/25108 Reimb Mileage Reimbursement 23.23
Total 23.23
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Allowed 20
Linda Acosta
In Sum of
23.23
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb 4343000 23.23 1 hereby certify that the attached invoice(s), or
bitl(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
12 -May 2008
U
ignature
23.23 Business Services Manager
Cost distribution ledger classification if 'Title
claim paid motor vehicle highway fund