155231 01/10/2008 CITY OF CARMFL, INDIANA VENDOR: 360144 Page 1 of 1
14 s L. ONE CIVIC SQUARE CYNTHIA CANADA
to CARMFL, INDIANA 46032 11508 LUCKY RAN DRIVE CHECK AMOUNT: $83.65
"iioH NOBLESVILLE IN 46060 CHECK NUMBER: 155231
CHECK DATE: 1/1012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 83.65 TRAVEL FEES EXPENSE
1 J GENERAL 1.11M NO. 101
PRESCRIBED BY STATE BOARD OF ACCOUNTS DEC 0 6 2007
DEPT j Q L[ 2 15 MILEAGE CLAIM �6 p
H E LI ,34 3 U TO
(GOVERNMENTAL UNIT) V —i
ON ACCOUNT OF APPROPRIATION NO. FOR
DSC
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER AUTO ILEAGE
DATE FROM TO READING NATURE OF BUSINESS MILES Cj Q
.19 POINT POINT START FINISH TRAVELED
PER MILE
I:fl l n 1� o n C '1?� n 4p-c
-0 14 T r
9
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AUTO LICENSE NO. TOTALS 7 S
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. l p_ 2—
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 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 correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
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Allowed 19 m w n a
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in the sum of x m
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 n (D
PRESCRIBED BY STATE BOARD OF ACCOUNTS FORM NC7..LD1 (198fi)
MILEAGE CLAIM L 0 6 2007
TO
(GOVERNMENTAL UNFr) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) I
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE x
NATURE OF BUSINESS MILES Q 4 5
0 A-c-a7 POINT POINT START FINISH TRAVELED
PER MILE
�r ,,y) T:�rC11)v i rte: I S n c e n r G e r
ma c r In G. f
10 c.J K O+�Y� C C r n
n 'AV
to L) r\ r r 5
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4- r ff I
AUTO LICENSE NO. TOTALS I 5, 1 Ll I ;L
G
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. I Cj 3
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 dui', after allowing all just cre i s
and that no part of the same has been paid. I
Date
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
r
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 Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/9/07 reimb. mileage reimbursement 83.65
Total
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.
Cyndi Canada Allowed 20
In Sum of
I-MP5
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 83.65 1 hereby certify that the attached invoice(s), or
r 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
4 -Jan 2008
S' hat e
3:Ivj Business rvi es Manager
Cost distribution ledger classification if Ti
claim paid motor vehicle highway fund