162834 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 356837 Page 1 of 1
0 ONE CIVIC SQUARE MICHELLE KRCMERY
CARMEL, INDIANA 46032 433 AUTUMN DRIVE CHECK AMOUNT: $119.01
CARMEL IN 46032
CHECK NUMBER: 162834
CHECK DATE: 8/20/2008
•tiEPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTIO
1160 4343004 53.24 TRAVEL PER DIEMS
1160 4355100 65.77 PROMOTIONAL FUNDS
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MARSH #14
2140 E. 116TH STREET
CARMEL, IN 46032
(317)575-3650
FRESH LUEA CUSTOMER 40005097724
3q 7 -UP PC 1 66 B
SC 3533 7 -UP .16
31 7 -UP PC 1.66 B
SC 3533 7 -UP .16 -B
31 7 PC 1.66 B
3 33 7 UP .16 B
31 7 UP PC 1.66 B
.533 7 -UP .16 -B
102 ICE MI WTI? 24/.5L PC o ,6 7 -F
3262 ICE MT WTR 24/.5L
553 CHOC CHIP MINI MUE 3.69 F
5q7 BANANA NOT MINI MU 3 69 1
4
5058 TCE CREAM COOP �.1'
FRUII TRY WOP 6U 12.99
1200 SHRP CHO CHS BALL 4.19 1
108 PECAN TEA COOKIES 5 99
108 PECAN TEA COOKIES 3 99 1
1911 KBLR TSI'D WHEAT
6351 TUASTEU MEDLEYS 3 1
F
7129 V RAINBOW SHR13T
xn� TRX .78 BAL 66.55
MARSH SUPERMARKET 414
2140 E. 116TH STREET
CARMEL, IN 46032
317 )575-•3650
EFI CREDIT PURCHASE: 08%11 /08 01:01 PM
CARD uxxxxxxxxxT
AUTH:586986 r
PAYMEEJl AMOUNT
66.
VF CREDIT 66.55
CHANGE 00
TOTAL NUmo
8/14/08
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 101 (1988)
MILEAGE CLAIM p
TO �l <r L ry )cq
(GOVERNMENT L UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
DATE FROM TO SPEEDOMETER AUTO MILEAGE
READING NATURE OF BUSINESS MILES Sg S 0
POINT POINT START FINISH TRAVELED PER MILE
tv c.,
Y
o S;
Cg C_.l.
Ulp I,LT v- I
AUTO LICENSE NO. TOTALS I n
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. I
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
-and that no art of, the same has been paid.
Date 1 /02
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
On Account of Appropriation No. for Disbursing Officer
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Allowed 19 x 0 a
in the sum of i? m
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A.E. BOYCE CO., INC. MUNCIE, IN 01136 n (D
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Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
8�18� 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
M ichelle KIZJEI499X Krcmery Purchase Order No.
4 33 Autumn Drive Terms
C armel IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/13/08 Milea e Loa Milea e reimb ursement for Michelle Krcmery t
city business
8 14/ 08 Receipt Refreshments for Jane Reiman portrait e vent
Total
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.
8/18/08
ALLOWED 20
M .chel l e Krcmer_y IN SUM OF
433 Autumn Drive
Carmel In 46032
119.01
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayors 4343004 4355100
Travel per diem Promotional Funds
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Mileage Log 4343004 $53.24 bill(s) is (are) true and correct and that the
Promotional 4355100 $65.77 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signatur%
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund