171731 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER
CHECK AMOUNT: $31.63
CARMEL, INDIANA 46032 12913 CURRIER STREET
CARMEL IN 46032 CHECK NUMBER: 171731
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUN PO NUMBER INVO NU MBER AMOUNT DESCRIPTION
1125 4343004 31.63 TRAVEL PER DIEMS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. ID) 119ES)
MILEAGE CLAIM
IGOVFAN UNl
ON ACCOUNT OF APPR RIATION NO. FOR
(OFFICE. BOARD, DEPARTMENT OR INSTrrUTION)
FROM TO SPEEDOMETER AUTO MILE
DATE R EADING i
2-d 0 POINT I POINT START FINISH NATURE OF BUSINESS TRAVELED r
PER 14 LE
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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 legally e, after a •chving all just credits
end that no part of the same has been paid.
Date
�,�f g
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.
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/15/09 Reimb Mileage 3/9/09 4/13/09 31.63
Total 31.63
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.
359600 Ballinger, Helen Allowed 20
12913 Currier Street
Carmel, IN 46032
In Sum of
31.63
L
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4343004 31.63 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
31.63 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund