159608 05/14/2008 ,a CITY OF CARMEL, INDIANA VENDOR: 360411 Page 1 of 1
0 ONE CIVIC SQUARE AARON SMITH CHECK AMOUNT: $89.28
CARMEL, INDIANA 46032 9773 SAN MARCO PASS
INDIANAPOLIS IN 46280 CHECK NUMBER: 159608
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343000 89.28 TRAVEL FEES EXPENSE
I
r
FRE:£CRIBED BY STATE BOARD OF ACCOUNTS
GENERAL FORM NO. 101 (1986)
MILEAGE CLAIM APR 2 2 2008 3 n
TO
BY;
(GOVERNMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILEAGE
D�A,T,E, READING MILES
POINT POINT START FINISH NATURE OF BUSINESS TRAVELED S
PER MILE
'Z /Z U E
3 CA-1-0. 9
C 1 0 o A
3
34 •l t
y/ Ck-
C-- -g
r
3 mac-
3
1-{
AUT 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 due, after allowing all just credits
;end that no p rt of t e same has been paid.
Date v
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.
Aaron Smith
Date Due
s
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
89.28
412108 Reimb. Milea a Reimbursement
Total 89.28
I 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
Aaron Smith
In Sum of
89.28
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343000 89.28 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
Sig atu
89.28 Business Se s Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund