177277 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 361801 Page 1 of 1
ONE CIVIC SQUARE ALYSSA KARSAS CHECK AMOUNT: $16.77
CARMEL, INDIANA 46032 15439 HARMON "PLACE
NOBLESVILLE IN 46060 CHECK NUMBER: 177277
<,o i
CHECK DATE: 9115/2009
D EPARTMENT ACCOUNT PO NUMBER INVO NUMB AMOUNT DESCRIPTION
1046 4343004 REIMB 16.77 TRAVEL PER DIEMS
L
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO, 10) (1986)
MILEAGE CLAIM
TO
ON ACCOUNT OF APPROPRIATION NO. FOR 10 rSO6
(OFFICE, BOARD. DEPARI'VENT OR INSTITUTION)
SPEEDOM
DATE FROM TO _J READING AUTO MILEAGE
NATURE OF BUSINESS MILES
POIN ar-1;
POINT FINISH TRAVELED I
T �T PER MILE
5 D n
r'?53r P r
'T 1H Wimm;i t' P
R "Q- 11
11
a Mm
Al fu Vilu rl
AUTO LICENSE NO. TOTALS I 3 �os 1 0 7
1
I i
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, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after aliowtng all just credits
and that no part of the same has been paid.
Date 7/
T
AUG 2 6 2009 UU
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.
Terms
361801 Karsas, Alyssa
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s))
16.77
7/30/09 Reimb. Mileage 7/3 7/30/09
Total 16.77
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.
361801 Karsas, Alyssa Allowed 20
In Sum of
16.77
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 16.77 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
10 -Sep 2009
Signature
16.77_ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund