166860 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA REYNOLDS CHECK AMOUNT: $33.93
CARMEL, INDIANA 46032 11410 BURKWOOD DRIVE
CARMEL IN 46033 CHECK NUMBER: 166860
CHECK DATE: 12110/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NU MBER AM OUNT DESCRIP
—1046 4343000 REIMB 33.93 TRAVEL FEES EXPENSE
Al
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a Dania nve+nu ur AU COUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM i
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR s
(OFFICE, BOARD, DEPARTMENT OR INSTn
i
SPEEDOMETER.
FROM TO AUTO MILEAGE
DATE READING NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED PER MILE
j 3 110 3� O i
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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 legally due, after'allowing all just credits
end that no part of the same has been paid.
Date —w_ f (P D a t�
i OL
I DEC 0 1 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.
361801 Reynolds, Alyssa Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/26/08 Reimb. Mileage 11/3/08 11/26/08 33.93
Total 33.93
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.
361801 Reynolds, Alyssa Allowed 20
In Sum of
33.93
NIT
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 33.93 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
33.93 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund