166640 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360417 Page 1 of 1
ONE CIVIC SQUARE JESSICA DAVIS CHECK AMOUNT: $29.83
CARMEL, INDIANA 46032
CHECK NUMBER: 166640
CHECK DATE: 12110/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 29.83 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENVIA1 FORW NO. 101 (1996)
n I MILEAGE CLAIM
C ARMEI� I�LA� IPt21G.S IbJD F�1WlOr�\
TO
(OOVERNIIENTAL U14IT1��
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF' ME, BOARD, DEPART1kNT OR ni SON)
FROM TO SPEEDOMETER AUTO
ES 0 5M
DATE READING
2 POINT POINT START FINISH NATURE OF BUSINESS TRAVE ED r
PER MILE
F
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 all just credits
end that no part of the same has been paid.
Date Tr 0 2008,
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.
360417 Davis, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/26/08 Reimb. Mileage 11/03/08 11/26/08 29.83
Total 29.83
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.
360417 Davis, Jessica Allowed 20
In Sum of
29.83
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000. 29.83 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
1 -Dec 2008
Signature
29.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund