166654 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 358991 Page 1 of 1
ONE CIVIC SQUARE GEORGIANNA EDWARDS CHECK AMOUNT: $165.91
0 CARMEL, INDIANA 46032 1630 E 67TH STREET
INDIANAPOLIS IN 46220 CHECK NUMBER: 166654
CHECK DATE: 12/1012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 16S.91 TRAVEL FEES EXPENSE
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM c 'a
TO
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO
SPEEDOMETER AUTO MILEAGE
D E READING NATURE OF BUSINESS MILES @o Q
POINT POINT START FINISH TRAVELED PER MILE
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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 le y u a ter at cr edits
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 p.*.oper 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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I A.E. BOYCE CO., INC. MUNCIE, IN 01136
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PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FOAM NO. 101 (1986)
MILEAGE CLAIM
TO G 0
(GOVERNMENTAL UNIT) J N O V 2 ?D J8
ON ACCOUNT OF APPROPRIATION NO. FOR v
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
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POINT POINT START FINISH TRAVELED PER MILE
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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. 8�
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 du after allowing all just credits
and that no part of the same has been paid.
Date
r
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
p' p'
a c o c
Allowed 19 w x a
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in the sum of
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A.E. BOYCE CO., INC. MUNCIE, IN 01136
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM �E-TV _T
TO I t
(GOVERNMENTAL UNIT) NOV 2 5 7Qn
ON ACCOUNT OF APPROP ATION NO. FOR
I
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) zr `r•
SPEEDOMETER AUTO MILEAGE
DATE FROM TO READING
19 POINT POINT START FINISH NATURE OF BUSINESS
TRAVELED Q
PER MILE
—4A 00 C �LA
a 'l 6 0 Y 6\ _l) Y'\U "I'lrac (A t a1
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AUTO LICENSE NO. TOTALS 1
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 e, fter allowing all just credits
and 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.
f
That it is apparently Sl correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o Cr a
a m o m
y n
Allowed 19_ w
in the sum of a p-
m
5
a
b tr
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a" a. o
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(Board or Commission) 0
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G
A.E. BOYCE CO., INC. MUNCIE, IN 01136 n a
i
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.
358991 Edwards, Georgianna Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/21/08 Reimb. Mileage 5!8108 11/21/08 165.91
Total 165.91
l 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.
358991 Edwards, Georgianna Allowed 20
In Sum of
165.91
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 165.91 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
165.91 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund