166179 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 360417 Page 1 of 1
ONE CIVIC SQUARE JESSICA DAVIS
CARMEL, INDIANA 46032 CHECK AMOUNT: $33.35
CHECK NUMBER: 166179
CHECK DATE: 11/24/2008
'DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 33.35 TRAVEL FEES EXPENSE
i�
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM 110. 10) (1986)
MILEAGI: CLAIM
TO
(GOVERNMENTAL DNI'I)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMYXr OR INSTITUTION)
SPEEDOMETER
DATE FROM To READING AUTO MILEAGE
2o- POINT POINT START FINISH NATURE OF BUSINESS TRAVELED
PER MILE
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
NOV 0
NOV 4 5 2008
�3Y� t
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.
Terms
360417 Davis, Jessica
Invoice Description Amount
Invoice (or note attached invoice(s) or bill(s))
Date Number 33.35
11/5/08 Reimb. Mileage 10/01/08 10/29/08
Total 33.35
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
33.35
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. A.CCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 33.35 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
17 -Nov 2008
1K&jZ&
Signature
33.35 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund