178346 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK AMOUNT: $46.37
INDIANAPOLIS IN 46206 CHECK NUMBER: 178346
CHECK DATE: 10/1412009
DEPARTMENT ACC OUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 46.37 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORIV 140, 101 JIM)
r y A MILEAGE CLAIM
t f Ml 7 KTJV'� TO
I60V NMENTAL UNI'n
ON ACCOUNT OF APPROPRIATION NO- FOR
JdFME. BOARD, DEFAATTUWr OR INSTMJTION)
SPEEDOMETER AUTO MILEAGE
DAnTE FROM TO I BEADING NATURE OF BUSINESS MILES e
p
Zb v POINT POINT START FINISH TRAVELED PER MILE
p _may C-r L
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3 t no>JO, c v ioo�gRct 3- o
TA
9 Cam'
0 I\AD" M e r p- v 7
r1 t t OD t CaAG -5 raG ✓M1_
1 c
5 0 c o C ora7r RAG iF 3 o lL otlbtl o t &P 3 Z� DD 1L MAKP- c.o41� ek--r- Z oN CrR w 0 y-- KRo6P.e --;r to 0 9Drh 0 P tupr_+t -q C t,-< 3 29 t7 N0 v�00D. i 3 1,5
5 -1 t.�t i.l rl e o ¢SDK i u o
-e M1 1199 1 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.�j
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 a dui, after allowin�alUljust credits
and t o a of th same as bee a•d.
J
Dat
OCT G' 6 2009
1�7e
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
9/30109 Reimb. Mileage 9/1 9130/09 46.37
Total 46.37
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.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
In Sum of
46.37
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#fTITLE AMOUNT Board Members
Dept
1046 reimb. 4343004 46.37 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
7 -Oct 2009
Signature
46.37 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund