206135 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 364750 Page 1 of 1
ONE CIVIC SQUARE JESSICA BALLINGER
CARMEL, INDIANA 46032 10830 TOOLEY CT CHECK AMOUNT: $96.85
APT IF CHECK NUMBER: 206135
INDIANAPOLIS IN 46234
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIMB 96.85 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORA NO. 101 (1980
MILEAGE CLAIM
To GSS i ca C� I n4 Qr
(GOVE)INMENTAL UNIT)
ON ACCOUNT OF APPROPRIATION NO. FOR
(OHICE, BOARD. DEFART MfT OR INSTTFUTION)
SPEEDOMETER AU idI1.EAGE
DATE FROM TO READING NATURE OF BUSINESS MIS Q S E
Z0 `dI� POINT POINT START FI ISH TAAVELE TO D
nn PER MILE
Sr� n 9
yvt P -7
9 1
1
F -71
i
(1
✓'tom l
i
L14.A�vY�- t.tn7�"
it It
i 11
r
ll
I
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 due, afte owing all just credits
and that no pail of the same has been paid.
Date
I o W 79
1
JAN 24'IM
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.
364750 Ballinger, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1120112 Reimb Mileage 1211/11 1119112 96.85
Total 96.85
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 1C 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
364750 Ballinger, Jessica Allowed 20
In Sum of
96.85
;F
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or Board Members
Dept
INVOICE NO. ACCT #/TITL AMOUNT
1081 -10 Reimb 4343000 96.85 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
9 -Feb 2012
Signature
96.85 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund