157076 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 355994 Page 1 of 1
ONE CIVIC SQUARE PAMELA GRIFFITHS
CARMEL, INDIANA 46032 12906 DOUBLE EAGLE DRIVE CHECK AMOUNT: $40.19
CARMEL IN 46033 CHECK NUMBER: 157076
CHECK DATE: 3/5/2008
[IE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4343002 40.19 EXTERNAL TRAINING TRA
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1966)
MILEAGE CLAIM
l-
AD A I I/ V TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO F READING
G T R AUTO MILEAGE
NATURE OF BUSINESS MILES x
19 POINT POINT START FINISH TRAVELED PER MILE
2 a C oK u r 4a-4-4 b (o e w W bn k U ci d
adb A- vb c&0a 7
l ivi e G� G�� �G C(W' /J6 T ct;vee .3 w o 1qA ,9r T oh 4 o
d0 C( �y 6 l �lsr u lli[� Cc �L�, C ZP
L360q 1 01W CA v L iWk New t 026 e 3
r 1 07 'l
a6' cce� r AT n
7 A6D c Gc yr rV Cti u 4
J a G ✓iC. '(•i. Gvt�L cam i 9�E 26� G11-- nZ Tv(- U
r a Jog c 2) Ve i LJ ,e (,Li 4(' --C✓Ze CI t4 Gt
7 a U'V<<, I V w U I t,
20 61 r- cr i h i �5 V i i Vr" l l
�d 'b t 44 V,"i. ✓Lc Z c'cCc- y V6 J "l ti� C�
i G' E' G i hi 1 t; `N k tl f
r r0 30a -L GV'� �i�i c;Ut �I �d f cC L �vo t� a Add
66 �i' d co c- 3 '-7f j5 J1JW D 7r?tt I
AUTO LICENSE NO. TOTALS I
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 due, after allowing all just credits
and that no. part of the same has been paid.
Date
Claim No. Warrant No.
I have examined the within claim and hereby
IN FAVOR OF certify as follows:
n Q^ That it is in proper form.
That it is duly authenticated as required
(r-, by law
That it is based upon statutory authority.
That it is apparently j correct
l incorrect
Disbursing Officer
On Account of Appropriation No. for
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Allowed 19 o w
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in the sum of b P N
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(Board or Commission) 0 n
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 i
0
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Pam Griffiths Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0-2/28/0-8 Mileagu- 40.40
Total
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.
ALLOWED 20
Pam Griffiths
IN SUM OF
40
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1202 Information Systems
Board Members
PO# or
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1202 430-02 k& r2LC fnateriaIs or services itemized thereon for
U0, which charge is made were ordered and
received except
20
gI atu;ee
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund