172991 05/27/2009 F CITY OF CARMEL, INDIANA VENDOR: 359461 Page 1 of 1
ONE CIVIC SQUARE NIKEESHA PITTMAN
CARMEL, INDIANA 46032 2713 HIGHLAND PLACE CHECK AMOUNT: $32.84
INDIANAPOLIS IN 46208
CHECK NUMBER: 172991
CHECK DATE: 5/27/2009
DEPARTMENT ACC PO NUMBE INVOICE NUMBER J AMOUNT DESCRIPTI
1046 4343004 32.84 TRAVEL PER DIEMS
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PFASCRIRED BY STATE BOARD OF ACCOUNTS GENERAL CORY NQ X01 ❑4ee7
MILEAGE CLAIM
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5PEEDOMETER
DATE FROM TO READING AUTO AGE
20 POINT i POINT START FINISH NATURE OF BUS]NES6 TRAVELED
PER MILE
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AUTO LICENSE NO- T 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 pro 'sions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is legal] due, after allowing all just credits
end that no part of t e s me has been paid.
Date
D I LI! MAY 0 7 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
4130109 reimb. Mileage 411/09 4130109 32.84
Total 32.84
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
1 20
Clerk- Treasurer
i
Voucher No. Warrant No.
359461 Pittman, Nikeesha Allowed 20
2713 Highland Place
Indianapolis, IN 46208
I n Sum of
32.84
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343004 32.84 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
21 -May 2009
Signature
32.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund