179646 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 358991 Page 1 of 1
4 ONE CIVIC SQUARE GEORGIANNA EDWARDS
CARMEL, INDIANA 46032 CHECK AMOUNT: $46.77
1830E 67TH STREET
INDIANAPOLIS IN 46220 CHECK NUMBER: 179646
CHECK DATE: 11/24/2009
DEPARTMENT ACC PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 REIMB 46.77 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNR
FNFRAL FOAM 110. 101 t19Bb)
MILEAGE CLAIM Imo,
TO eQ I 1 1 i ezfi/ 4:: l�
gg
(GOVERNMENTAL UNIT) F
ON ACCOUNT OF AP PR PRIATION NO- FOR
(OFMCE, BOARD. DFP"TWX T OR 1NSr[nrrI0X)
-SPEEDOMETER AUTO
r1e DATE FROM To I READING NATURE OF BUSINESS MILES Qr
POINT POINT START FINISH TRAVELED PER MILE
A4 7
a
1r
t+
Morlon Ne
TT.
AUTO LICENSE NO. TOTALS
S 77
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 legapafter ng all just credits
end that no part of he same has been paid.
Date
d 0
a NOV lJ 2009 eel'—
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r
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.
358991 Edwards, Georgianna Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1113109 Reimb, Mileage 8130 1115109 46.77
Total 46.77
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.
358991 Edwards, Georgianna Allowed 20
In Sum of
46.77
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 46.77 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
19 -Nov 2009
Signature
46.77 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund