159263 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 360144 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA CANADA
i CHECK AMOUNT: $133.36
CARMEL, INDIANA 46032 11508 LUCKY DAN DRIVE
o� NOBLESVILLE IN 46060 CHECK NUMBER: 159263
CHECK DATE: 5114/2008
-P ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D ESCRIPTION
'1046 4343000 D14062332 108.36 TRAVEL FEES EXPENSE
1046 4359000 D14062332 25.00 SPECIAL PROJECTS
X25, CCU
MAY o 5 200$
Extended School Enrichment
T
Employee Referral Program 1046:4359000
ESE Employee: Start Date of Referral:
31 i jC
Name of Referral: ESE School Site:
ES Employee Signature Date
SE D' 'sion Manager Signature Date
RFCFTVF�
PRESCRIBED BY STATE BOARD OF ACCOUNTS lv t7J/
F R 2 2 20.08 GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) 1
ON ACCOUNT OF APPROPRIATION NO. FOR C C CC— (l�Gt
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE
19 POD POINT START FINISH NATURE OF BUSINESS TR AVELE D 50 s x
PER MILE
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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.
Date
Claim No. Warrant No. I have examined the within claim and hereb}
IN FAVOR OF certify as follows:
That it is in proper form,
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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A.E. BOYCE CO., INC. MUNCIE, IN 01136
p FRESCRMED BY STATE BOARD OF ACCOUNTS R P' 9_ T A�� f 16 Al �j GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM APR' 2 7009
TO
(GOVERNMENTAL UNTT)
ON ACCOUNT OR APPROPRIATI
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING AUTO f"�; 10. LF4�
19
POINT POINT START FINISH TRAVELED OF BUSINESS TRAVE Q x
PER MILE
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AUTO LICENSE NO. TOTALS Lo 1
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map, I OS. 3co
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 d e, after allowing all jus
.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 correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o tr w
a
CD
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Allowed 19_ k
in the sum of m
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A.E. ROYCE CO., INC. MMCIE, 47 01136
R.F F� l6 Ali,
PRESCRIBED BY STATE BOARD OF ACCOUNTS A 2 2 2008 NER
GEAL FORM NO. 101 (1986)
MILEAGE CLAIM t
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INS TITU ION)
FROM TO READING +R A MILEAGE
DATE NATURE OF BUSINESS MILES_
19 POD POINT START FINISH TRAVELED PER MILE
i a re- r1 A i fi
11 Jh ,�ov d �r0 v
f rh re- -k' f'n S e_
i Z' CD e
P r n 4-E:) S i e
a e'er
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2 I f 0 c yy
#kr
'r' C-
S
AUTO, LICENSE NQ. I TOTALS 3 9 c
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, u after allowing all just credits,
end that no par of the same has been paid.
Date
Claim No. Warrant No. I have examined the within claim and hereb}
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is a correct
apparently incorrect
Disbursing Officer
On Account of Appropriation No. for
o W a+
P. m p
p O H
m
Allowed 19— A w
in the sum of P' m. m
K
m
m m
H
Co O
P.
r P. O
tr (Board or Commission) N n
M rt
FILED m
�p
w w
F W
rt M
(Official Title)
O fD
4 O.
A.E. BOYCE Co., INC. MUNCIE, IN 01136
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.
Cyndi Canada
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
512!08 Referral Employee Referral Bonus 25.00
4118/08 Reimb. Mileage Reimbursement 01128 -04118 108.36
Total 133.36
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Allowed 20
Cyndi Canada
In Sum of
133.36
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1046 Referral 4359000 25.00 1 hereby certify that the attached invoice(s), or
1046 Reimb. 4343000 108.36 bill(s) is (are) true and correct a, nd that the
materials or services itemized thereon for
which charge is made were ordered and
received except
12 -May 2008
Sign Vices
133.36 Business Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1