157572 03/19/2008 CITY OF CARMEL, INDIANA VENDOR: 360934 Page 1 of 1
ONE CIVIC SQUARE CAMERON MASON
e CARMEL, INDIANA 46032 3943 S 400E CHECK AMOUNT: $46.44
TIPTON IN 46072 CHECK NUMBER: 157572
CHECK DATE: 3/19/2008
DEPARTMENT ACCOUNT PO NUMBER I NVOIC E N UMBER AMOUNT DESCRIPTION
2201 4343002 46.44 EXTERNAL TRAINING TRA
e Ua d Dr 3— Board ai A oaml..
gal orm No. 101 (lbt
r MILEAGE CLAIM
DR.
t tGOV RNM6NTAL UNIT) TO
IY l�
ON ACCOUNT OF APPROPRIATION NO. -FO
(OFFICE. BOARD. DEPA TMENT OR INSTITUTIO
SPEEDOMETER i I AUTO MILEAGE
DATE FROM TO II READING+ MILES
NATURE OF BUSINESS I TRAVELED PER MILE
POINT POINT 1I START I FIN ISF' 1
t 1 111 11 r Itfl 1
1
I
I
I I
i
I
I
I
I I
I
AUTO LICENSE NO. I I 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 legally due. after allowing. all just cred
and that no part of the same has been paid. 1
Bate
Claim No. Warrant No. I have examined -the within -claim and,hereby
IN FAVOR OF certify as follows:
T'nat it is in proper form.
C A In tY m rI SGT That. it is -duly authenticated as required
ti J al �L� L T— by law.
That it is based upon statutory authority.
That it is apparently correct
incorrect
q `I
On Account of Appropriation No. for Dis ursinq f icer J
xq
Allowe 19_ R
in the sum of 40 o
co
a
o m o
y o.
CD
a
QQ n O R N
(Board or Commission)
n"
FILED
(Official Title) a o
CL y
o a M
c. oru ee., .u,nc, mo. ann n 7