206962 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 362295 Page 1 of 1
ONE CIVIC SQUARE DAVID BARNES
i CHECK AMOUNT: $139.86
CARMEL, INDIANA 46032 5634 RIDGE HILL WAY
4 ,o� AVON IN 46123 CHECK NUMBER: 206962
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4343002 139.86 MILEAGE
nN ill-r- Ur- t.;LA1R9
Ca TO KV-p— HC_T?�� ►�1P DR.
I (Governmental Unit
lud AQ On Account of Appropriation No. 22pp for T 1 rc�yP
(Office, Board, Department or Institution
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE SSS`
20 12 Point Point Start Finish TRAVELED PER MILE
Ct Ul C 5 c DAT J SGT oo L 3 yG .S
t aeye Si C'rc� C s c` C-
31 1 9
b) 12DJI F Ni cF�t5 t L C S Cc..t co c- 96,
Auto License No. TOTALS 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
allowing all just credits, and that no part of the same has been paid.
Date Z b e—k-r
2
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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
Dave Barnes
Purchase Order No.
Engineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a Mileage; to Purdue Road School $139.86
d
Total Total
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. d
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Dave Barnes IN SUM OF
Engineering Department
$132.60
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a n/a 2200 4343002 $139.86 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
12-12 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund