180119 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 363619 Page 1 of 1
ONE CIVIC SQUARE AUDREY HUGHEY
€Q� CHECK AMOUNT: $38.50,
-r� CARMEL, INDIANA 46032 11940 WESTWOOD DR
CARMEL IN 46033 CHECK NUMBER: 180119
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1047 4343003 38.50 TRAVEL LODGING
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO 101 tI98M
MILEAGE CLAIM
A
on
AL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR OR
3 PO,� �3
(OFFICE. BOARD, DEPARTMENT OR INSTITUTION) q34 o:�
AUTO M E
FROM TO ii _4GE
DATE READING
NATURE OF BUSINESS MILES
POINT POINT START FINISH TRAVELED PER MILE
I rp 01
MCI
i X A
I
--4
T
7-
AUTO LICENSE NO. TOTALS
"TEEDOMETER READING c olu mns are to be used only when distance between points cannot he determined by fixed mileage or official highway map.
T Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed i s legally after allowing all just credits
and that no pal 01 the same has been paid,
Date
Au&d t) Wos
h-ar C)n M
D\J
I ckleck� +-o-, So her
P/bo-p of was 61� DEC 0 3 2009
ny:�
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.
363619 Hughey, Audrey Terms
11940 Westwood Drive
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
38.50
12/1/09 Reimb. NRPA mileage
Total 38.50
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
i
Voucher No. Warrant No.
363619 Hughey, Audrey Allowed 20
11940 Westwood Drive
Carmel, IN 46033
In Sum of
38.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members
Dept
1047 Reimb. 4343003 38.50 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
3 -Dec 2009
m'M
Signature
38.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund