164673 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 360282 Page 1 of 1
ONE CIVIC SQUARE ALICIA DECKARD CHECK AMOUNT: $90.09
CARMEL, INDIANA 46032 6147 W 1050 S
FORTVILLE IN 46040 CHECK NUMBER: 164673
CHECK DATE: 10/16/2008
DEPARTMENT ACCOUN PO NUMB INVOICE NUMBER A MOUNT DESCRIPTION
1046 4343000 90.09 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS q GENF,RALFORM NO. 101 (1986)
MILEAGE CLAIM
TO ;L�c.r yt gG
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OF,ICE, BOARD, DEPARTL¢]1T OR INST[rUTION)
SPEEDOMETER AUTO AGE
DAT FROM TO READING NATURE OF BUSINESS MILES Va S
2 V POINT POINT START FINISH TRAVELED
PER MILE
cl 7 Z le lF t f• i
Gi cr IL/ (e tr 17 l l41 r 1
i
rU t r t' 0- 7I C l! C!
AUTO LICENSE NO. TOTALS Q V�
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 legal y due, aft r a bowing all just credits
and that nno art of the same has been paid.
Date
�D
S E P 3 0 2008
BY:
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.
360282 Deckard, Alicia Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/26/08 Reimb. Mileage 9/2/08 9/24/08 90.09
Total 90.09
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.
360282 Deckard, Alicia Allowed 20
In Sum of
90.09
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 90.09 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 -Oct 2008
Signature
90.09 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund