158045 04/01/2008 CITY OF CARNIEL, INDIANA VENDOR: 361086 Page 1 of 1
ONE CIVIC SQUARE JACOB C MOORE
CARMEL, INDIANA 46032 10822 LANTERN VIEW OR APT 108 CHECK AMOUNT: $28.01
FISHERS IN 46038 CHECK NUMBER: 158045
CHECK DATE: 4/1/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESC
1046 4343000 28.01 TRAVEL FEES EXPENSE
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PRESCRIBED 13Y STATE BOARD OF ACCOUNTS
GENERAL f-PRM NO.. ;01 (1986)
aEC1�, EAGE CLAIM
-f FEB 2 0 2008 To Jacob /i'I oo e
(GOVERNMENTAL UNIT)
BY: ON ACCOUNT OF APPROPRIATION NO. FOR
J (OFFICE, BOARD, DEPARTMENT OR INSTITUTION) i
DATE FROM TO SPEEDOMETER AUTO MILEAGE
READING NATURE OF BUSINESS MILES SO; S
19 POINT POINT START FINISH TRAVELED
PER MILE
-0 rye Elr y vies Pe le /'a
j2 z I r 1 U 7
r 7 So o
l.-
lj 8-0
o
j 7 3. 50
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i AUTO LICENSE NO. TOTALS 54
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 penalt of Chapter 155, Acts 1953 I here certi that the forec oin account is 'ust and correct, that the amount claimed is le all due after aliowin all 'usOed 'ti I
P P P y Y T 9 J g Y g J
and that no pa t of the same has been paid.
Date
2- g-�_
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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.
Jacob Moore Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/8/08 reimb. mileage reimb. 28
Total 28.01
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.
Jacob Moore Allowed 20
In Sum of
28.01
ON ACCOUNT OF APPROPRIATION FOR
104- Program Fund
PO# or Board Members
Dept
INVOICE NO. ACCT #/TITLE AMOUNT
1046 reimb. 4343000 28.01 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
S' natu
28.01 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund