164728 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1
ONE CIVIC SQUARE PAMELA GRIFFITHS CHECK AMOUNT: $58.50
CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 164728
CHECK DATE: 10/16/2008
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUNT DESCRIPTION
1202 4343002 58.50 EXTERNAL TRAINING TRA
IN
d
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
5 l MILEAGE CLAIM 'N
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READING SPEEDOMETER AUTO
NATURE OF BUSINESS MILES cQ 0
19 POINT POINT START FINISH TRAVELED
PER MILE
nVi c u
Q ��Lc Gt
-Y7 S t
(o Irl1w a ei'c
d rh,Y6 r-5a�
c b r 7S/
7111
T �'G C C- 7 i V Fit 9 Ci
'7 i G 5 tn/ 1
cCCSC- f �T ire
7/ 9 6 l G
7 08 c CC 1 l
o l'� r ff
o x i iGr`
o G y� Q dr�e- cc u. o
l 6 I L- uL G� c� c�V 2 H r
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 foregoing account is just and correct, that the amount claimed is le ae, after allowing all just credits,
and tha o part of the sa�m e has been paid.
Date
r
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR 9F certify as follows:
That it is in proper form.
L That it is duly authenticated as y required
q
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
v.
Disbursing Officer
On Account of Appropriation No. for
0
p C
Allowed 19_ w
o w a
M
in the sum of m
a
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a
m
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p a n
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(Board or Commission) O o
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FILED m P. a
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to M
to `C
(Official Title) o M
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A -E. BOYCE CO., INC. MUNCIE, IN 01136 to 0 'i
Prescribed State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
P ars, Griffiths Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/08/08 Mileage
8.50
Total
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
VOUCHER I 13/08 WARRANT NO.
Tam CZ riff
ALLOWED 20
z
IN SUM OF
$58.50
ON ACCOd#�W�XEFQFPLTION FOR
1202 Informatin Systems
Board Members
PEOT or INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
430 $58.50 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
20
N gnatu e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund