155702 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 358408 Page 1 of 1
ONE CIVIC SQUARE TIFFANY DETERS
CARMEL, INDIANA 46032 5264 N CENTRAL CHECK AMOUNT: $92.34
INDIANAPOLIS IN 46220 CHECK NUMBER: 155702
CHECK DATE: 112312008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1'046 4343000 92.34 TRAVEL FEES EXPENSE
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JIVE 1.
PRESCRIBED BY STATE BOARD OF ACCOUNTS F GENERAL FORM NO. 101 (1986)
JAN ZOOS DEPT MILEAGE CLAIM
rl b
TO
(GOVERNMENTAL UMT)
DESC r�If
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING NATURE OF BUSINESS MILES 142.5-
o a-O-a7 POINT POINT START FINISH TRAVELED PER MILE
1 o✓lo
1 Z 06 ✓1
)Z
i
I
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 er allowing all just credits
and that no part of the same has been paid.
Date
P-
I 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' a
w o
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Allowed 19
a
in the sum of `d m ro
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a
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ro o ro
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(Board or Commission) 0
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FILED O.
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 n a
�°r� ur t 10�
PRESCRIBED BY STATE BOARD OF�ACCOUNT5
F
E GENERAL FORM NO. 101 (1986)
JAN 1 4. 2008 bEPT 10L1 MILEAGE CLAIM
(GOVERNMENTAL= UN €T•) l r� V
DESC 1 ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING NATURE OF BUSINESS MILES
>e� 7 POINT POINT START FINISH TRAVELED
PE R MIL E
Z 4 V10 V1
d d
I D 11 a n
11 0 c )Y SS
I I �'1 o trio d Csz Cam,
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CL VI-CA s E q.
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1z_/ Co vlo r� i
)7-1(2- d
Y' Or 1p +'1 W_ lZ r3 IF
1 Z 13 a� vk e4 v on i,
v rwvr C
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, ue, after allowing all just credits
and that no part of the same has been paid. i
j
Date
B
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 a correct
ppaiently
incorrect
On Account of Appropriation No. for Disbursing Officer
o tr a
a N 0
0
Allowed Ig a n 0
m H
in the sum of w m
co m
a
0 P)
m
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a y.
N ry
H m
a
rn a
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0
(Board or Commission) 0
p. a
A
FILED a a a
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m
m
(Official Title) W
1 S H O H
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N
a.E. BOYCE co.. INC. MUNCIE, IN ai i35 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
i whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Tiffany Deters Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/14/08 Reimb Req Mileage reimb. 13.19
1/14/08 Reimb Req Mileage reimb. 79.15
Total 92.34
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Tiffany Deters Allowed 20
In Sum of
92.34
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1048 Reimb Req 4343000 92.34 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 -Jan 2008
Signature
92.34 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund