165321 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 362074 Page 1 of 1
ONE CIVIC SQUARE NATALIE LOVE
CARMEL, INDIANA 46032 2470 CHASEWAV CT CHECK AMOUNT: $95.53
INIDPLS IN 46268
CHECK NUMBER: 165321
CHECK DATE: 10/2912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 95.53 TRAVEL FEES EXPENSE
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PRESCRINBD BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM i
TO r�+a�
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO FOR
(OFFICE, BOARD, DEPARTMENT OR INSTIITUTION)
SPEEDOMETER
DATE FROM TO READING AUTO MILEAGE
NATURE OF BUSINFSS MILES a
POINT POINT START FINISH TRAVELED P M ILE
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t
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;L
ILA
d u
AUTO LICENSE NO. TOTALS
f SPEEDOMETER READING columns are to be used only when distance between points be determined by fixed mileage or official highway map. J
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, er allowing all just credits
..end that no part of the same has been paid.
Da €e
Claim No. Warrant No. I have examined the within claim and hereby
IN FAVOR OF certify as follows:
That it is in proper form.
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 P
C'o�
Allowed 3 9_ R. tr 0
0
0'
0
in the sum of m gy
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 Q in
PRESCRIBED BY STATE BOARD OF ACCOUNTS 1
GENERAL. FORM NO. 161 (1986)
MILEAGE CLAIM
To BY. (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR (OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO READING SPEEDOMETER
AUTO MILEAGE
p
NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED PER MIL
MCI
CA C-"*
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AUTO, LICENSE NO. TOTALS J
SPEEDOMETER READING columns are to be used only when distance between points be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally du fter allowing all just credits
.end that no part of the same has been paid.
Date
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.
Love, Natalie Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/13/08 Reimb. Mileage 7129108 10/13/08 95.53
Total 95.53
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.
Love, Natalie Allowed 20
In Sum of$
95.53
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
04b Reimb. 4343000 95.53 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
17 -Oct 2008
Signature
95.53 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund