178125 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363065 Page 1 of 1
ONE CIVIC SQUARE JAMES DOWELL CHECK AMOUNT: $37.84
;•,�o CARMEL, INDIANA 46032 C/O PARKS ESE
CHECK NUMBER: 178125
CHECK DATE: 1011412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE A MOUN T DESC
`1046 4343004 REIMB 37.84 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENF.AAL FOAN NO. 101 11986)
MILEAGE CLAIM
so
(GOVFRNHENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, DEF&RTHENT OR INSTn UElON)
SPEEDOMETER
;Z0 DA FROM TO I READING NATURE OF BUSINESS M a 5
R S r
POINT POINT START FINISH TRAVELED
PER MILE
o e rlrs 7
iDri o PO �v+e ti 7
If11on c; 6 s `r' 73
f� na>1 G vn el 7
1 1 6, b Y
Mon Dn e 4 1 73
O 73
ry) On
AUTO LICENSE NO. 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 provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is leg after aliowing all just credits
end that no part of the same has been paid.
Date i C) r ,lg
�7- O'D
.,a
QCT 0 6 2009 s
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.
363065 Dowell, James Terms
14328 Banister Dr
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9011109 Reimb. Mileage 9121 9130109 37.84
Total 37.84
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.
363065, Dowell, James Allowed 20
14328 Banister Dr
Noblesville, IN 46060
4
In Sum of
37.84
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 37.84 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
7 -Oct 2009
Signature
37.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund