156791 02/21/2008 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: $23.23
INDIANAPOLIS IN 46280 CHECK NUMBER: 156791
CHECK DATE: 2/21/2008
DEPARTMENT ACCOUNT PO NUMB IN VOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 23.23 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GFr.�RAL'FOftld NO. 101 (1986)
MILEAGE CLAIM I f
FUND TO S Ct C4 Q1 I(A Qh I
(GOVERNMENTAL UNIT) JAN 1 8 ,2008
ON ACCOUNT OF APPROPRIATION NO. FOR I
S
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) N �IJ
DATE FROM TO SPEEDOMETER READING AUTO MILEAGE
NATURE OF BUSINESS MILES x
I9 POINT POINT START FINISH TRAVELED PER MILE
Z C �c /tom a Nfi ►M�
ap t .,ecr D g.S' 7 5•
C E r b 2
No CIE 2 r.
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ar K K& O. 1 14
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AUTO LICENSE NO.
TOTALS S
V
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 d4le, after aliowing all just credits
znd that no part of the am�pe has been paid.
Date 101
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.
Sam Richardson Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/18/08 reimb. mileage reimbursement 23.23
Total 23.23
I 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
i
Voucher No. Warrant No.
Sam Richardson Allowed 20
In Sum of
23.23
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1046 Reimb 4343000 23.23 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
13 -Feb 2008
a W/
Sig t re
23.23 Business Se s Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund