171815 04/29/2009 CITY OF CARMFL, INDIANA VENDOR: 360417 Page 1 of 1
ONE CIVIC SQUARE JESSICA DAVIS
I€ 0 CHECK AMOUNT: $34.65
CARMEL, INDIANA 46{732
CHECK NUMBER: 171815
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUM AMO DESCRIPTION
1046 4343004 34.65 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD Or ACCOUNTS GENERAL 1011W NO. 101 0-
MILEAGE CLAIM
/1
TO
l�p,LtMEL LAS{ (GOk2fr s a�►A S icd
(OOVF11NlfENTALUNI'n ON ACCOUNT OF APPROPRIATION NO. FOR
END W
xM Ft? 61J OWIAEt�IT
(OFFICE, BOARD. DEP.ARTKOCr OR IN5rr777r10N)
NATURE OF BUSINESS MILES 55 FROM TO LL SPEEDOMETER AUTO WJEAGE
DATE
READING
POINT POINT START FINISH
TRAVELED PER WLF
O
f
AUTO LICENSE NO. TOTALS
SPEEDOMETER READING columns are to be used only when distance between points cannot he 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 legally due, after aliowing all just credits
and that no part of the same has been paid.
i
Date
l
A 2 0 2009
]BY:
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be property 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.
360417 Davis, Jessica Terms
Y
1
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
31301Q9 Reimb. Mileage 3121Q9 3I30f09 WS
34.65
Total 34.65
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.
360417 Davis, Jessica Allowed 20
In Sum of
34.65
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO #or INVOICE NO. ACCT #1TITL AMOUNT Board Members
Dept
1046 Reimb. 4343004 34.65 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
22 -Apr 2009
Signature
34.65 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund