175226 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 363145 Page 1 of 1
ONE CIVIC SQUARE NATHAN WOESTE
is 0 1, CARMEL, INDIANA 46032 C/0 -PARKS ESE CHECK AMOUNT:
CHECK NUMBER: 17522 175226
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343004 REIMB 11.34 TRAVEL PER DIEMS
PRY-SCRIBED BY $SATE BOARD OF ACCOUNTS
GENERAL FORM PG. 101 11980
MILEF:GE CLAIM �,�,k�,�,\ WDGrjy'�
C_�. -p
IOOVERNMENIAL UNIT}
ON ACCOUNT OF APPROPRIATION NO. FOR
1OFrICE, BOARD. DEPAAT ]Xr OR INSTRVnON7
FROM TO SPEEDOMETER AUTO MILEAGE
DATE READING NATURE OF BUSINESS MILES CL
POINT POINT START FINISH ]'AAVELT•D
P LE
F �iT
ti L'.r; a U1lC: I• i "�t� t�,s' tG�• G�-'
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, 1 hereby certify that the foregoing account is just aadcorrect, that the amount claimed is legally due, after aliowing all just credits
and that no parl of the same has been paid.
Date
JUL 0 7 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.
Woeste, Nathan Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
713109 Reimb. Mileage 6126109 713109 11.34
Total 11.34
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
Voucher No. Warrant No.
Woeste, Nathan Allowed 20
In Sum of
11.34
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TlTLE AMOUNT Board Members
Dept
1046 Reimb. 4343004 11.34 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
16 -Jul 2009
Signature
11.34 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund