165934 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA REYNOLDS CHECK AMOUNT: $33.34
CARMEL, INDIANA 46032 11410 BURKWOOD DRIVE
CARMEL IN 46033 CHECK NUMBER: 165934
CHECK DATE: 11/12/2008
DEPARTMENT a x ACCOUNT PO NUMBE INVO N UMBER AMOUNT DESCRIPTION
1046 4343000 33.34 TRAVEL FEES EXPENSE
1986
PRESCRIBED BY STATE HOARD OF ACCOUNTS GENERAL FORM NO. 10]
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) M sw 11 I 1_P V VdS
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOM +R AUTO MILEAGE
NATURE OF BUSINESS MILES
0 POINT POINT START FINISH TRAVELED PER MILE
1 F l VON MWtS3
P W 1ANN LkftA i
IV 1
3s
f
�'b V MAM' 1
'4 i F sa'�� r►, L, °W�z tom.
20 11 FJ�E
A E K broTY r PLAAnp 1 3,0
Nit I i fs 1 1 v o\ Mit 'A-ttl) (V
In 5 pL_ MID= 1
x
Inno
AUTO LICENSE NO. TOTALS ej i O 3 .�I 3.9
SPEEDOINTER 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 alI j i st credits
2nd that no part of the same has been paid.
i
Da te
I I
ACCOUNTS PAYABLE VOUCHER
r 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
10/31/08 Reimb. Mileage 10/1/08 10/31/08 33.34
Total 33.34
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.
361801 Reynolds, Alyssa Allowed 20
L
In Sum of
33.34
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 33.34 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
4 -Nov 2008
Signature
33.34 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund