165110 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 00350221 Page 1 of 1
ONE CIVIC SQUARE LINDA ACOSTA
CARMEL, INDIANA 46032 CIO PARKS CHECK AMOUNT: $17.12
CHECK NUMBER: 165110
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN DESCRIPTION
:1046 4343000 17.12 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS .1 ENERAL FORS! RO. 101 (1984)
MILEAGE CLAIM C k �7
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE,. BOARD, DEPARTMIDiT OR INSTITUTION) 7
D(A�Tpn FROM SO S READ NGE +ER AUTO �MD EAGE
PONT PONT START FINISH NATURE OF BUSINESS TRAVELED E
PER MILE
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F t
i
i
1 V
AUTO LICENSE NO. TOTALS JL-
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 gust and correct, that the amount claimed is legally due, a ez aliowing all just credits
end that no part of the same has been paid.
Date
RE c rs T
OCT 1. 7 'CC8
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.
,3
Payee
Purchase Order No.
00350221 Acosta, Linda Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/17/08 Reimb. Mileage 918108 10/17/08 17.12
Total 17.12
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 10 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No, Warrant No,
00350221 Acosta, Linda Allowed 20
In Sum of
17.12
l
f
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 17.12 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
20 -Oct 2008
Signature
17.12 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund