207072 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 365463 Page 1 of 1
ONE CIVIC SQUARE MATTHEW GREGORY CHECK AMOUNT: $204.99
CARMEL, INDIANA 46032 C/O ESE
CHECK NUMBER: 207072
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 204.99 TRAVEL FEES EXPENSE
PRCSCftIBCD HY STATC BOARD Oi ACCOUNTS GENERAL FORL 110. 101 (1406)
MILEAGE CLAIM M �h'� 6 y-
I/1
TO 1
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD. DUART EWT OR INSTITUTION)
SPEEDOMETER AUTO EA.GE
D NATURE OFSUSINES6
FROM TO READING MIL£S Q. t1p., s
Zo IE TE
POINT POINT START FINISH TRAVELED PER MILE
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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. bW oG
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 aliowing all just credits
end that no part of the same has been paid.
Date
I k
i. i k
L 0 5 2012A
t ,1,
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FOR(/ NO. lot (1986)
MILEAGE CLAIM
TO
(GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE BOARD, DEPARTMENT OR INSTMrrION)
T SPEEDOMETER
FROM TO
ZO r f BEADING AUTO MILEAGE
NATURE OF BUSINESS MILES Q, s,�f
POINT POINT STRAT FINISH TRAVELED PER MILE
OS
L
8G
T 1
r I' 1 ttLs arl�vtks v h'r U
Etvs t Z �a Ghoul
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to
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, after at' ing all just credits
and that no part of the same has been paid.
Date
d f i,tii 5 1111
��a
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.
365463 Gregory, Matthew Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/18/12 Reimb Mileage 11/30/11 2/27/12 204.99
Total 204.99
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.
365463 Gregory, Matthew Allowed 20
In Sum of
204.99
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1081 -7 Reimb 4343000 204.99 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
8 -Mar 2012
P &)qU&
Signature
204.99 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund