161716 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER
CARMEL, INDIANA 46032 12913 CURRIER STREET CHECK AMOUNT: $30.81
stir+ CARMEL IN 46032
CHECK NUMBER: 151716
CHECK DATE: 7/23/2008
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
:"1047 4343000 30.81 TRAVEL FEES,& EXPENSE
I
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PRESCRIBED BY STATE BOARD OF ACCOUNTS
G ENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
C EI TO
(GOV ENTAL UNIT) JUL 0 8
y� 2008 ON ACCOUNT OF AP OPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) i`
DATE FROM TO READING AUTO MILEAGE
POINT POINT STAR FINISH NATURE OF BUSINESS TRAVELED 510. E x
PER MILE
CITY HALL: I 0 S
1-
PtA LL, 1. 8
14 r 11 9. Lf
02 6AIU d- g oo Tal "A"
5 2 I t
Ala ILL G H k 1 3
s 3 g� a; l 3
0� b� OT >L'7�t/z 6 l,�-cG[,� -sr �I �rt;sE (.4rr ira• -�c B l
!L rr
15 vat
ZA
a C'5 1.2 T.
11
It
JUL 9 20H
�ctc
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 11 just credits
end that no part of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently I correct
i incorrect
Disbursing Officer
On Account of Appropriation No. for
o W a
0) m 0 0
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Allowed 19_ 0 a
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in the sum of m
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(Board or Commission) 0 p
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FILED G-
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(Official Title) 0
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(D
A.E. BOYCE CO., INC. MUNCIE, IN 01136 tJ Q+
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.
359600 Ballinger, Helen Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/8/08 reimb. Mileage 4/15/08 7/2/08 30.81
Total 30.81
1 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.
359600 Ballinger, Helen Allowed 20
In Sum of
30.81
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 reimb. 4343000 30.81 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
16 -Jul 2008
Signature
30.81 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund