155487 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360204 Page 1 of 1
ONE CIVIC SQUARE SAMUEL RICHARDSON
11109 ECHO CREST EAST DRIVE CHECK AMOUNT: $25.22
CARMEL, INDIANA 46032
INDIANAPOLIS IN 46280 CHECK NUMBER: 155487
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 25.22 TRAVEL FEES EXPENSE
10 L1
PRESCRIBED BY STATE BOARD OF ACCOUNTS `i-� j\ w�
GF <'.�IEP4 L FOP �1 1;0. 101 (1986)
D
gAT MILE. GE GE CLAIM
LJLl�IE ll l /DO TO �'\/t/\ R U iJ' 1 2- V 0 `j
1 r V F
(GOVERNMENTAL UNIT) 0 j �'T'�
ON ACCOUNT OF APPROPRIATION NOL L FOR 1
i
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION) DEC 20
0
U
DATE FROM TO SPEEDOMETER p
READING -v 0 AUTO MILEAGE
19 NATURE -OF- BUSINESS._` I MILES
POINT POINT START FINISH TRAVELED PER MILE
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AUTO LICENSE NO.
TOTALS 2— 5 ZZ
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 foreq. ping account is just and correct, that the amount claimed is legally d after aliowing all just credits
end that no part of the same has been paid. j
Date
I
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
'IAn 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
25.22
11/28/07 reimb. mileage reimbursement
Total 25.22
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
4
Voucher No. Warrant No.
Sam Richardson Allowed 20
In Sum of
25.22
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343000 25.22 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 -Jan 2008
Signa re
25.22 Business S is /Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund