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176405 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 363270 Page 1 of 1 0 ONE CIVIC SQUARE LAUREN REISING io CARMEL, INDIANA 46032 5759 COOPERS HAWK DRIVE CHECK AMOUNT: $3.91 CARMEL IN 46033 CHECK NUMBER: 176405 CHECK DATE: 8119/2009 DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1046 4343004 3.91 TRAVEL PER DIEMS PRESCRIBED BY STAS£ BOARD OF ACCOUNTS GENERAL FORM NG. ICI 119067 MILEAGE CLAIM LA A VAY-) P p 5G0 N1fENTA4 UN11Y f S r C S ON ACCOUNT OF APPROPRIATION NO. FOR (07,=. B OARn, Dr3ARTim1'r OR INSTrWrTON) MILEAGE SPEEDOMETER DATE FROM TO E READING AUTO NATURE OF BUSINESS MILES d• 2 POINT POINT START FINISH 7AAVELIiD PEA to 0 r AUTO LICENSE NO. TOTALS 'SPEEDOMETER BEADING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway. map. 111 Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the loregoing account is just and correct, that the amount claimed is 1 ally due, after 6110WIng all just credits am end that no part of the same has been paid. Date i �[o ©o �a C} 200 J 1t2,AVCL 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. Reising, Lauren Terms Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 7/29/09 Reimb. Mileage 7/20/09 3.91 Total 3.91 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. Reising, Lauren Allowed 20 In Sum of 3.91 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 Reimb. 4343004 3.91 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 13 -Aug 2009 Signature 3.91 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund