173506 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 360491 Page 1 of 1
ONE CIVIC SQUARE ERIC PURNELL
CHECK AMOUNT: $106.56
12185 PEBBLE ST CARMEL, INDIANA 46032
LINiT 300 CHECK NUMBER: 173506
FISHERS IN 46038
CHECK DATE: 6110/2009
DEPARTMENT ACCOUN P O NUMBER INV NUMBER AMOUNT DESCRIPTION
1046 4343004 REIMB 106.56 TRAVEL PER DIEMS
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PRESCRIBED BY STATE BOARD OY ACCOUNTS GENERAL FOR14 NO. 171 ;26857
MILEAGE CLAIM
TO
Tcpv�M6NrA ur�
ON ACCOUNT OF APPROPRIATION NO. FOR
COMCE, BOARD. DEPARTMENT OR INSTITUTION)
FROM TO SPEEDOMETER AUTO MILER E
DATE READING LES
z° POINT POINT START FINISH NATURE OF BUSINESS I TRAVELED !j il C 4
PER MILE
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64 Pr-
W) Y4P�'1
el
vi a t 1 C
Nona
Man
arm
fArL Zl1r?_�L 1
f f e
4- 5
r UTA G Y ✓ao� 5. 1 1
AUTO LICENSE NO TOTALS P5
SPEEDOMETER �j
SPEEDOMETER READING columns are to he used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuan? to Lhe provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is tegall ae, after aliowing all just credits
j
and that no part of the same has been paid,
Date
i
c__, JUN 0 2 2009
PRESCRIBED BY STATE NOARD OF ACCOUNTS GENERAL FORI4 NO 101 (1983)
c MILEAGE CLAIM
f34 Y Tp
lco EBr1,veNTAa uN Tr ON ACCOUNT OF APPROPRIATION NO. FOR
IOMCP, BOARD. DEPA.R WET OR INST1TIMON)
§P DOMETER
DATE FROM TO READING k AUTO MFLE E
NATURE OF BUSINESS MILES C
z� POINT i POW START FINISH TRAVELED 1'
PER MILE
.Mra I n•t Af )r°�, r� a ��l --Q?'�
T Y) Baal
I 4 merh d 0 14 17 11
r d v
!i
I`
AUTO LICENSE NO-
TOTALS f
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 loregoine account is just and correct, that the amount claimed is le due, fter allowing all just credits
1 end. that no pa of the same has been paid.
Date
Z �7
JUN 0 2009
iLJe
p•.
l A
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.
360491 Purnell, Eric Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/29109 Reimb Mileage 312!09 4129109 81.51
5129109 Reimb Mileage 5/1/09 5127109 25.05
Total 106.56
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
360491 Purnell, Eric Allowed 20
In Sum of
106.56
ON ACCOUNT OF APPROPRIATION FOR
i
104 Program
PO# or INVOICE NO. ACCT#MTLE AMOUNT Board Members
Dept
1046 reimb. 4343004 81.51 I hereby certify that the attached invoice(s), or
1046 reimb. 4343004 25.05 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
4 -Jun 2009
Signature
106.56 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I