164150 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 361920 Page 1 of 1
r, ONE CIVIC SQUARE DAVID BITTELMEYER CHECK AMOUNT: $75.47
CARMEL, INDIANA 46032 8195 WESTFIELD BLVD
INDPLS IN 46240 CHECK NUMBER: 164150
CHECK DATE: 9/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
1046 4343000 75.47 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM No. 101 (1986)
MILEAGE CLAIM
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
ESE
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
FROM TO READING AUTO MILEAGE
DATE NATURE OF BUSINESS MMES
POINT POINT START FINISH TRAVELED PER MILE
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0 ;b�Q T re M o n� n e e�°�� S( i q0 S I. ,�c,ad S S G q
IT Ca,•es 1ce2 no.n Cs 1 Z6 ELI
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1372
S Z1 e�•e rr c2e_ c C �,.�er 9 I o C� P r.r �-1 l
Z Mono N -Z Lf "t
q Cl k C', �I 4 "7 1 �l -1 P r«f 4 C', 4
R/L CT- R o re n I 7 4 ti
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1/1( T S6 p /S69 �ieo✓.
q Mai war 6 I 6 4
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AUTO LICENSE NO. TOTALS Zq
SPEEDOMETER READING columns are to be used only when distance between points.cannot be determined by fixed mileage or official highway map. ZS. '-f (o5
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.
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.
Bittelmeyer, David Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/5/08 Reimbursement Mileage 8/12/08 9/5/08 75.47
Total 75.47
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Allowed 20
Bittelmeyer, David
In Sum of
75.47
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimbursement 4343000 75.47 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
15 -Sep 2008
Signature
75.47 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund