159431 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 359179 Page 1 of 1
ONE CIVIC SQUARE JASON KARSAS
a 0 i CHECK AMOUNT: $125.99
CARMEL, INDIANA 46032 1450 ROYAL LAKE CIRCLE
INDIANAPOLIS IN 46228 CHECK NUMBER: 159431
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 125.99 TRAVEL FEES EXPENSE
it
C II�1`EI�
.PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOAM NO. 161 (1986)
MILEAGE CLAIM APR 18 2008
TO
BY:
(GOVERNMENTAL UNIT) ON ACCOUNT Oi APPROPRI FOR �e C r 42�CS A-�
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION
SPEEDOMETER
FROM TO READING AUTO MILEAGE
DATE NATURE OF BUSINESS MILES S0 S' 1
19 POINT POINT START FINISH TRAVELED PER MILE
4.
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P I re ur P t
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of
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AUTO LICENSE NO. TOTALS
o
r
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. G i Ae,a Pallowing4 67 5 p 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 all jus cre its,
.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:
That it is in proper form.
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
CL
o rr a
D o
0
n N
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Allowed 19_ t o a
M r. (D
In the sum of
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(Board or Commission) 0
FILED
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(Official Title) 0 o c'"D
C 'iD
A.E. BOYCE Co., INC. MUNCIE, B4 01136 A P-
PRESCRIBED BY STATE BOARD OF ACCOUNTS t GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR jS�YI
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
SPEEDOMETER
DATE FROM TO READING
AUTO MILEAGE
19 POINT POINT START FINISH NATURE OF BUSINESS MILES
TRAVELED PER MILE
N K• v .r
7 222
/SL 4
i ,,4
Q4
.31 Z2
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 legally du after allowing all just credits
and that no part of the same has been paid.
Date
L
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 require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o W a
PL
M
O H
M a
Allowed 19_ m w G
in the sum of M m
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w
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b
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o
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w P. o
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(Board or Commission) 0 n
Q+ ID r
FILED (D Er-
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p
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lD
(Official Title) o o �o
M Er M
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 t M
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM SPEEDOMETER
DATE READING AUTO MILEAGE NATURE OF BUSINESS MILES
19 POINT POINT START FINISH TRAVELED PER MILE
oj►d
3 ac) 91.7
h
a 3
31
r_ •rte
mac. .9 i� 5�.� P
H G
n ,n Vic- e w l
U ph 1 L� Su t _•S
LA
"11 r 3 ..S
SO.3
6 1 29
y I �r
e _Q
AUTO LICENSE NO. TOTALS
3= ys.a
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 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 hereb}
IN FAVOR OF certify as follows:
That it is in proper form.
That it is duly authenticated as require
by law
That it is based upon statutory authorii
That it is apparently correct
incorrect
Disbursing Officer
On Account of Appropriation No. for
o W
o
m
Ul �y 0
O
A
Allowed 19_ (D 0 0
in the sum of
w
m w
CD
g
o
m
m
as te 0
o
(Board or Commission) o n
gL rt
FILED
p
Ip;
M
(Official Title) o
0
R7
A.E. BOYCE CO., INC. MUNCIE, IN 01136
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.
Jason Karsas
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4118108 Reimb Mileage 125.99
Total 125.99
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
Jason Karsas
In Sum of
125.99
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb 4343000 125.99 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
12 -May 2008
Si nature
125.99 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund