177118 09/15/2009 CITY OF CARMEL, INDIANA VENDOR 361920 Page 1 of 1
ONE CIVIC SQUARE DAVID BITTELMEYER CHECK AMOUNT: $171.60
CARMEL, INDIANA 46032 8195 WIFSTIFIEW BLVD
sM1 .?a. INDPLS IN 46240 CHECK NUMBER: 177118
CHECK DATE: 9/1512009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 171.60 TRAVEL PER DIEMS
4
PRESCRIBED BY STATE BOARD OF ACCOUNTS
GENFRAL FORM NG. ICI I19M
7 MILEAGE CLAIM
VEANMENTAL UNI11
ON ACCOUNT OF APPROPRIATION NO- FOR
(OFFICE, BOARD, DEPAHTHMa OR INS-MTTiON)
SPEEDOMETER
DATE FROM TO READING AUTO
POINT POINT START FINISH MATURE OF BUSINESS TRAVELED
PER M_ ILE
I G-t 14 43 LA uo
7 CSt n t I k
I LA tit
7 r o n uo
L C.T U uo
LAD
L M o t 4 o
L L i 0
fie arc f 'mil 2 C�
5 CN n n SO
M 9, 0
Ur
LA q0
1 L Q t-1 40
i Mnna C, fA "0
1 u t4
of cT�— `b ti u v
AUTO LICENSE NO. TOTALS j 1 GO
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 due, a ter allowing all just credits
end that no rt of thesaame has been paid.
7
Date f]� 1
AUG 2 8 2009
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.
361920 Bittelmeyer, David Terms
Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/24109 Reimb. Mileage 6/2 8/19/09 171.60
Total 171.60
I 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
r
Voucher No. Warrant No,
Bittelmeyer, David Allowed 20
361920
In Sum of
1
171.60
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 171.60 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
10 -Sep 2009
Signature
171.60 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund