180238 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 360491 Page 1 of 1
ONE CIVIC SQUARE ERIC PURNELL
CARMEL, INDIANA 46032 12185 PEBBLE Sr CHECK AMOUNT: $72.93
UNIT 300 CHECK NUMBER: 180238
FISHERS IN 46038
CHECK DATE: 12/8/2009
DEPART ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 REIMB 72.93 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENRRAL FORM NO. 101 ON6)
0 MILEAGE CLAIM
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ERNMENTA'L 1�71M1'1
ON ACCOUNT OF APPRpPRIATION NO. FOR
IOFiICE, BORRO. DEPARTMB]rr OR imsm Ur1ON)
SPEE DOMETER
DATE FROM TO I READING AUTO tLiLE__�GE
Z POINT POINT START FINISI; NATURE OF BUSINESS MILE
PEA MILE
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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 legall e, of r al' fng all just credits
and that no part of the same has been paid.
Date
i� PCA r1 ell
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ACCOUNTS PAYABLE VOUCHER
s CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, ra #es 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
11/25/09 Reimb Mileage 10/7 11/25/09 72.93
EEE E Total 72.93
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
20�
Clerk- Treasurer
i
Voucher No. Warrant No.
360491 Purnell, Eric Allowed 20
In Sum of
72.93
ON ACCOUNT OF APPROPRIATION FOR
104 Program
PO# or INVOICE N0. ACCT #/TITLE AMOUNT Board Members
Dept
1046 reimb. 4343004 72.93 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
3 -Dec 2009
Signature
72.93 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
4