158099 04/01/2008 INDIANAPOLIS IN 46280 CITY OF CARMEL, INDIANA VENDOR: 360204 Page 1 of 1
ONE CIVIC SQUARE SAMUEL RICHARDSON
CARMEL, INDIANA 46032 11109 ECHO CREST EAST DRIVE CHECK AMOUNT: $26.26
CHECK NUMBER: 158099
CHECK DATE: 4/1/2008
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUN DES CRIPTION
1046 4343000 26.26 TRAVEL FEES EXPENSE
j
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENEA:� -FORM NS. 101 (1986)
RECEIVE ILEA I GE CLAIM I�
TO f G (Z -15--c
FEB 2 0 2008
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
�Y• I
(OFFICE, BOARD, DEPARTMENT OR 3NSTITUTION) f
DATE FROM TO i SPEEDOMETER AUTO MILEAGE
J READING NATURE OF BUSINESS MILES 57c)
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 foregoi_r account is just and correct, that the amount claimed is legally due,, `fter allowing all just credits
and that no part of the same has been paid.
Date
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.
i
Payee
Purchase Order No.
Sam Richardson Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/18/08 reimb. mileage reimb. 26.26
Total 26.26
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.
Sam Richardson Allowed 20
In Sum of
26.26
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 26.26 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
25 -Mar 2008
na re
26.26 Business S ces Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund