175859 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN
CHECK AMOUNT: $31.89
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE
INDIANAPOLIS IN 46208 CHECK NUMBER: 175859
CHECK DATE: 816/2009
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 REIMB 31.89 TRAVEL PER DIEMS
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PRPSCflIBCp HT srArr BOARD OF ACCOUNTS
GENERAL FORM NO. 107 (1985)
MILEAGE CLAIM
TO
IGOVERNKENIAL 041TI
ON ACCOUNT OF APPROPRIATION NO.
tOFi1CR, BOARD. DEPA TWZ(T OR 1NSrrnrr10N)
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING
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POINT POINT START F1N1SH NATURE OF BUSINESS TRAVELED 6 55'
PER MILE
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AUTO LICENSE NO. TOTAZS
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is ley lly due, after aliowing all just credits
end that no part of the same has been paid_
Date n t" C%
0003
a
JUL I 0 1009 ryrtl
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
i
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/30109 reimb. Mileage 612/09 6/29/09 31.89
Total 31.89
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
31.89
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/T1TLE AMOUNT Board Members
Dept
1046 reimb. 4343004 31.89 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
30 -Jul 2009
Signature
31.89 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I