170365 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 360417 Page 1 of 1
ONE-CIVIC SQUARE JESSICA DAVIS
CARMEL, INDIANA 46032 CHECK AMOUNT: $23.10
ti ;yoho CHECK NUMBER: 170365
CHECK DATE: 4/1/2009
D EPARTMENT ACCOUN PO N UMBER INVOICE NUMB AMOUNT DESCRIPTION
1046 4343004 REIMB 23.10 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNT5 GENERAL FORM NO. IN p"s)
MILEAGE CLAIM
ii 1'O
C A RNIEL LAA Pa s aa', 1AZtO�I n A
(GOVERNMENTAL UNITI r 1 y
Ci�E�DED Ei.afSl�aM ON ACCOUNT OF APPROPRIATION NO. FOR 333...
[OF7[CJ:, 8 AAD, DEPAATNt]IT O8 1N lONJ
DATE FROM TO READING FR AUTO AGE
POINT i POINT S7AA7 FINISH NATURE OF BUSINESS MM �S �J
rRAVELBD PER MILL
r
AUTO LICENSE NO. TOTALS
SPEEDOMETER BEADING 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 L egally doe, after allowing all just ore its
and that no part of the same has been paid.
Date
MAR 8 2009
i f
1
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.
360417 Davis, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2127109 Reimb. Mileage 212109 2/27109 WB 23.10
Total Is 23.10
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
t
23.10
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #,rrlTLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 23.10_ 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
25 -Mar 2009
Signature
23.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund