164815 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 362020 Page 1 of 1
ONE CIVIC SQUARE DAWN LINGELBAUGH CHECK AMOUNT: $18.72
CARMEL, INDIANA 46032 1089 HALFMOON LANE
aN CICERO IN 46034 CHECK NUMBER: 164815
CHECK DATE: 10/1612008
5
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4343002 18.72 EXTERNAL TRAINING TRA
Claim No. Warrant No. I have examined the within claim and'hereby
certify as follows:
IN FAVOR OF That it is in proper form.
e— That it is duly authenticated as required
by law
That it is based upon statutory authority.
That it is apparently correct
incorrect
Disbursing Officer
On =Account of Appropriation No. for
o tr a
fD .0
N
N 0 0
Allowed 19_ M 0 w
(D?� a
(D M
in the sum of b m
y
a
a
N
P
y (D
H
p P. 0
O
f
(Board or Commission) 0 0
CL (D ZT
a
FILED
cD
kr' p
a 0
rA
W
fA
(Official Title) O o
O p" r
<D b p
tr, q i
A.E. BOYCE CO., INC. MUNCIE, IN 01136 O
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
6�-eno" L/
MILEAGE CLAIM
(GOVE ENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, I)EPAETTMENT OR MS1
DA FROM TO READ T SPEEDOMETER AUTO MI AGE
DATE D TE NATURE OF BUSINESS MILES x
�9 POINT POINT START FINISH TRAVELED
PER MILE
LC-Q,C
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 legall due, after ow' g all just credits
and that no part part of the same has been paid.
Date 200
Prescribed by 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
Dawn Wrigelbaugh Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10i07108 mileage
Total $18.72
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�_0[1-3A�fVARRANT NO.
Paw Inge augh ALLOWED 2 0
IN SUM OF
$18.72
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1201 Human Resources
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
430 02 $18 2 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Si, ature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund