163659 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC 'SQUARE CYNTHIA CANADA
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE CHECK AMOUNT: $94.33
ror NOBLESVILLE IN 46060 CHECK NUMBER: 163659
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMO D ESCRIPTION
1046 4343000 94.33 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INS 101;)
SPEEDOMETER
FROM
DATE TO READING MILES GE
NATURE OF BUSINESS
19 POINT POINT START FINISH TRAVELED
PER MILE
F. C- a6 W V
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c.
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AUG 2 7 2808
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J AUTO LICENSE NO. AI S L5:9 o 9
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, 1 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.
ate 6hglos gh�//6F 3
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM("
TO
(GOVERNMENTAL. Ulm) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
FROM TO READING AUTO MILEAGE
DATE NATURE OF BUSINESS MSS 0 5175
19 POINT POINT START FINISH TRAVELED PER MILE
10 0q oaL
Ca I;q 6 1 r,—,e
O �n e
r v Q e-, L -r r\
r) I rno k
rr '0 n i i
Al
AUG
BY:
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 allowing' all just credits
and that no part of the same has been paid.
D ate
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
(GOVERNMENTAL. UNIT) ON ACCOUNT OF APPROPRIA`T'ION NO. FOR AUG 2 7 ZOO$
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) BY:
DATE FROM TO SPEEDOMETER AUTO MILEAGE
READING NATURE OF BUSINESS MILES
19 POINT POINT START FINISH TRAVELED PER MILE
77 1
ho
rn
M G
s' e 3.
C) P e r n c j nr a
e.-c
a m o
1 c he
n
7 rakA n
AUTO LICENSE NO. TOTALS 7
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
,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.
360144 Canada, Cyndi Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8127108 Reimbursement Mileage 6/19/08 8121108 94.33
Total 94.33
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.
360144 Canada, Cyndi Allowed 20
In Sum of
94.33
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimbursement 4343000 94.33 i 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
27 -Aug 2008
7` wu-
Signature
94.33 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund