179374 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK AMOUNT: $50.11
INDIANAPOLIS IN 46208
CHECK NUMBER: 179374
CHECK DATE: 11/11/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 50.11 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 103 {1986}
r MILEAGE G
To TRAVEL- Me Vi (0
U 4
GX �f)QIc t
(GOVERNMENTAL tiN {j
ON ACCOUNT OF APPROPRIATION NO. FOR V
l•' �(OFF .ICE B OARD. A DEP K Aa -6 TMFxr o tNs n urioa)
SPEEDOMETER
AUTO 5, E
DATE FROM TO READING 4
2-Q POINT POINT START FINISH NATURE OF BUSINESS 1•AA EV o C) 5�'
PER MILE
D C WCO �oC�K t o KElz– U V L Z 6 1 3
4
ou is GE R coR�S I 2- 3� I. 193
D !o� GEkr t'av Tbu[ T&- I 33
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:3
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I
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 gally ue, after allowing all just credits
and that n art of the same has been paid.
Date RUE fl) ru:Ys t�.ts✓ csrwacn�
1 OCT 3 2009
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.
359461 Pittman, Nikeesha Terms
2713 Highland Place Date Due
Indianapolis, IN 46208
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/30/09 Reimb. Mileage 10/1- 10/30/09 50.11
Total 50.11
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
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
50.11
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343004 50.11 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
5 -Nov 2009
Signature
50.11 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund