158718 04/17/2008 CITY OF CARMEL, INDIANA VENDOR: 360491 Page 1 of 1
ONE CIVIC SQUARE ERIC PURNELL
10 CARMEL, INDIANA 46032 7933 CARLTON ARMS APT B CHECK AMOUNT: $68.09
INDIANAPOLIS IN 46204 CHECK NUMBER: 158718
CHECK DATE: 4117/2008,
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 68.09 REISSUE CHECK 155869
I
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PRESCRIBED BY STATE BOARD OF ACCOUNTS TC� T p GENERAL FORM NO, >nl (1986)
1 MILEAGE CLAIM
TO 1Ai,l 2 Q 8 LI NE 2
(GOVERNMENTAL UNIT) yY,
S�'
ON ACCOUNT OF APPROPRIATION O._ FOR
(OFFICE, BOARD, DEPARTMENT OR II'7STITUTION) &J 1
SPEEDOMETER
DATE FROM TO 'READING AUTO MILEAGE
NATURE OF BUSINESS MLLES Q k 8 d
19 POINT POINT START FINISH TRAVELED PER MILE
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iJ C'c� Ci` G tt fi
11 iL.. G� (I.vvl/
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AUTO LICENSE NO, TOTALS 4 s
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
end that no part of the same has been paid.
Date 7
�1 o�
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. far
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Allowed 19— k t a_
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PU
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(Board or Commission)
FILED EP
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(Official Title) o m
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A.E. BOYCE CO.. INC. MUNCIE. IN 41136 1g C M••
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
r. whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Eric Purnell Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/15/08 reimb. 2007 Mileage reimb. 68.09
Total 68.09
l hereby certify that the attache invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
Clerk- Treasurer
Voucher No. Warrant No.
Eric Purnell Allowed 20
In Sum of
68.09
ON ACCOUNT OF APPROPRIATION FOR
104- Program Fund
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1 046 reimb. 4343000 68.09 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 -Jan 2008
Sig ture
68.09 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund