158124 04/01/2008 «f CITY OF CARMEL, INDIANA VENDOR: 358684 Page 1 of 1
ONE CIVIC SQUARE SHANNON SHERMAN CHECK AMOUNT: $175.56
CARMEL, INDIANA 46032 18816 WIMBLEY WAY
o� NOBLESVILLE IN 46060 CHECK NUMBER: 158124
«an V
CHECK DATE: 4/112008
DEPARTMENT ACCOUNT PO NUMBER INV N UMBER AMO DESCRIPTION
1046 4230200 13.59 OFFICE SUPPLIES
1046 4239039 3.90 GENERAL PROGRAM SUPPL
1046 4343000 158.07 TRAVEL FEES EXPENSE
f
PRESCRIBED BYSrIM BOARD OF ACCOUNTS �gg- T g^p GENERA FORM N6.101 (1986)
C �R/ D
MILEAGE CLAIM
Ile To 1iL� 0 7 2008
'71717 Z17 41'11na (GOVERN MENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR_
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
j
SPEEDOMETER
DAYS FROM TO I READING MILES e
NATURE OF BUSINESS
1� POINT POINT START FINISH TRAVELED PER MILE
y�
rt
x qq ga 5 7, i
I
190r7 s
®T
7 nlh�ti &9 9 $v 7
vt_ 12 7` ;z G7
k 9d
d'; ij t2G9�L. +vl2l CG.' c',C9. L GC
t-
P C7 r
i"jDYIOr? CG 1,�c70 G. -"7/
AUTO LICENSE NO. TOTALS
11 ,2 3 O
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway, map.
Pnrsuar t #o.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&ie, 4fter allowing all just credits
and tfiat 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:
1 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 e
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Allowed 19_. n w
in the sum of m
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tyj a rt
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o
(Board or Commission) m
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(Official Title) o
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A.Z.. BOYCZ CO., INC. MMCIZ, IN 01136 n
Carm 0 Clay
Parks &Recreate ®n
Employee Expense Reimbursement Request
Date of
Receipt Vendor listed on receipt Fund Department Account Line Account Description Amount Purpose of Expense
62 L16 3
-1 7� Z -30
All receipts should be attached in the same order as listed above.
TOTAL
Name (print) r�(i al/I a /c°ymI en
Check Address
payable to: 7MA 1 2008
City, St, Zip
gnature //j�� -F� �'�iL� Date:
Approved by: Date:
Revised 3-2-07 by Busines S ices
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.
Shannon Sherman Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/15/08 Reimb Req mileage reimb. 158.07
3/17/08 Reimb Req ESE supplies 17.49
Total 175.56
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
6
Shannon Sherman Allowed 20
In Sum of$
175.56
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb Req 4343000 158.07 1 hereby certify that the attached invoice(s), or
1046 Reimb Req 4239039 3.90 bill(s) is (are) true and correct and that the
1046 Reimb Reg 4230200 13.59 materials or services itemized thereon for
which charge is made were ordered and
received except
25 -Mar 2008
Sig u e
175.56 Business Se is j Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund